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Cox LA, Thompson WJ, Mundt KA. Interventional probability of causation (IPoC) with epidemiological and partial mechanistic evidence: benzene vs. formaldehyde and acute myeloid leukemia (AML). Crit Rev Toxicol 2024; 54:252-289. [PMID: 38753561 DOI: 10.1080/10408444.2024.2337435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 03/25/2024] [Indexed: 05/18/2024]
Abstract
INTRODUCTION Causal epidemiology for regulatory risk analysis seeks to evaluate how removing or reducing exposures would change disease occurrence rates. We define interventional probability of causation (IPoC) as the change in probability of a disease (or other harm) occurring over a lifetime or other specified time interval that would be caused by a specified change in exposure, as predicted by a fully specified causal model. We define the closely related concept of causal assigned share (CAS) as the predicted fraction of disease risk that would be removed or prevented by a specified reduction in exposure, holding other variables fixed. Traditional approaches used to evaluate the preventable risk implications of epidemiological associations, including population attributable fraction (PAF) and the Bradford Hill considerations, cannot reveal whether removing a risk factor would reduce disease incidence. We argue that modern formal causal models coupled with causal artificial intelligence (CAI) and realistically partial and imperfect knowledge of underlying disease mechanisms, show great promise for determining and quantifying IPoC and CAS for exposures and diseases of practical interest. METHODS We briefly review key CAI concepts and terms and then apply them to define IPoC and CAS. We present steps to quantify IPoC using a fully specified causal Bayesian network (BN) model. Useful bounds for quantitative IPoC and CAS calculations are derived for a two-stage clonal expansion (TSCE) model for carcinogenesis and illustrated by applying them to benzene and formaldehyde based on available epidemiological and partial mechanistic evidence. RESULTS Causal BN models for benzene and risk of acute myeloid leukemia (AML) incorporating mechanistic, toxicological and epidemiological findings show that prolonged high-intensity exposure to benzene can increase risk of AML (IPoC of up to 7e-5, CAS of up to 54%). By contrast, no causal pathway leading from formaldehyde exposure to increased risk of AML was identified, consistent with much previous mechanistic, toxicological and epidemiological evidence; therefore, the IPoC and CAS for formaldehyde-induced AML are likely to be zero. CONCLUSION We conclude that the IPoC approach can differentiate between likely and unlikely causal factors and can provide useful upper bounds for IPoC and CAS for some exposures and diseases of practical importance. For causal factors, IPoC can help to estimate the quantitative impacts on health risks of reducing exposures, even in situations where mechanistic evidence is realistically incomplete and individual-level exposure-response parameters are uncertain. This illustrates the strength that can be gained for causal inference by using causal models to generate testable hypotheses and then obtaining toxicological data to test the hypotheses implied by the models-and, where necessary, refine the models. This virtuous cycle provides additional insight into causal determinations that may not be available from weight-of-evidence considerations alone.
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Affiliation(s)
- Louis A Cox
- Cox Associates and University of Colorado, Denver, CO, USA
| | | | - Kenneth A Mundt
- Independent Consultants in Epidemiology, Amherst, MA, USA
- Adjunct Professor of Epidemiology, University of Massachusetts, Amherst, MA, USA
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2
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Chiavarini M, Rosignoli P, Sorbara B, Giacchetta I, Fabiani R. Benzene Exposure and Lung Cancer Risk: A Systematic Review and Meta-Analysis of Human Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:205. [PMID: 38397694 PMCID: PMC10887806 DOI: 10.3390/ijerph21020205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
Lung cancer is a leading cause of death with nearly 1.8 million deaths estimated worldwide in 2020. Although benzene is classified as a human carcinogen (Group 1) on the basis of its association with acute myeloid/non-lymphocytic leukaemia, there is still limited evidence that it may influence lung cancer risk. This study examined the potential link between benzene exposure and risk of lung cancer using a systematic review of epidemiological studies and meta-analysis. We searched through PubMed, Web of Science and Scopus databases up to 10 February 2023 to identify all articles on the association between benzene exposure and lung cancer (incidence or prevalence) and/or mortality. We extracted the risk estimates of the highest and the lowest reported categories of benzene exposure and conducted a meta-analysis using a random-effects model. Heterogeneity and publication bias were analysed using an I2 test and funnel plots asymmetry, respectively. Twenty-one studies were included in the final analysis, with a total of 10,750 lung cancer cases and 2899 lung cancer deaths. Overall, risk estimates of lung cancer prevalence and mortality in association with benzene exposure were 1.20 (n = 14; 95% CI 1.05-1.37) and 1.15 (n = 13; 95% CI 1.02-1.30), respectively. In all cases, heterogeneity was quite large, while no significant publication bias was observed. When only studies that adjusted for smoking habit were selected, the risk for lung cancer increased by up to 34% (n = 9; 95% CI 1.10-1.64). Our data, which show a strong association between benzene exposure and lung cancer risk, may have important public health implications. However, further studies are needed to identify the lung cancer risk associated with benzene exposure considering different smoking conditions.
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Affiliation(s)
- Manuela Chiavarini
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, 60126 Ancona, Italy;
| | - Patrizia Rosignoli
- Department of Chemistry, Biology and Biotechnology, University of Perugia, 06123 Perugia, Italy; (P.R.); (B.S.)
| | - Beatrice Sorbara
- Department of Chemistry, Biology and Biotechnology, University of Perugia, 06123 Perugia, Italy; (P.R.); (B.S.)
| | - Irene Giacchetta
- Department of Medicine and Surgery, Section of Public Heath, School of Hygiene and Preventive Medicine, University of Perugia, 06123 Perugia, Italy;
| | - Roberto Fabiani
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, 60126 Ancona, Italy;
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3
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Wan W, Peters S, Portengen L, Olsson A, Schüz J, Ahrens W, Schejbalova M, Boffetta P, Behrens T, Brüning T, Kendzia B, Consonni D, Demers PA, Fabiánová E, Fernández-Tardón G, Field JK, Forastiere F, Foretova L, Guénel P, Gustavsson P, Jöckel KH, Karrasch S, Landi MT, Lissowska J, Barul C, Mates D, McLaughlin JR, Merletti F, Migliore E, Richiardi L, Pándics T, Pohlabeln H, Siemiatycki J, Świątkowska B, Wichmann HE, Zaridze D, Ge C, Straif K, Kromhout H, Vermeulen R. Occupational Benzene Exposure and Lung Cancer Risk: A Pooled Analysis of 14 Case-Control Studies. Am J Respir Crit Care Med 2024; 209:185-196. [PMID: 37812782 PMCID: PMC10806413 DOI: 10.1164/rccm.202306-0942oc] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 10/06/2023] [Indexed: 10/11/2023] Open
Abstract
Rationale: Benzene has been classified as carcinogenic to humans, but there is limited evidence linking benzene exposure to lung cancer. Objectives: We aimed to examine the relationship between occupational benzene exposure and lung cancer. Methods: Subjects from 14 case-control studies across Europe and Canada were pooled. We used a quantitative job-exposure matrix to estimate benzene exposure. Logistic regression models assessed lung cancer risk across different exposure indices. We adjusted for smoking and five main occupational lung carcinogens and stratified analyses by smoking status and lung cancer subtypes. Measurements and Main Results: Analyses included 28,048 subjects (12,329 cases, 15,719 control subjects). Lung cancer odds ratios ranged from 1.12 (95% confidence interval, 1.03-1.22) to 1.32 (95% confidence interval, 1.18-1.48) (Ptrend = 0.002) for groups with the lowest and highest cumulative occupational exposures, respectively, compared with unexposed subjects. We observed an increasing trend of lung cancer with longer duration of exposure (Ptrend < 0.001) and a decreasing trend with longer time since last exposure (Ptrend = 0.02). These effects were seen for all lung cancer subtypes, regardless of smoking status, and were not influenced by specific occupational groups, exposures, or studies. Conclusions: We found consistent and robust associations between different dimensions of occupational benzene exposure and lung cancer after adjusting for smoking and main occupational lung carcinogens. These associations were observed across different subgroups, including nonsmokers. Our findings support the hypothesis that occupational benzene exposure increases the risk of developing lung cancer. Consequently, there is a need to revisit published epidemiological and molecular data on the pulmonary carcinogenicity of benzene.
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Affiliation(s)
- Wenxin Wan
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Susan Peters
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Lützen Portengen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Ann Olsson
- International Agency for Research on Cancer/World Health Organization, Lyon, France
| | - Joachim Schüz
- International Agency for Research on Cancer/World Health Organization, Lyon, France
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
- Faculty of Mathematics and Computer Science, Institute of Statistics, University of Bremen, Bremen, Germany
| | - Miriam Schejbalova
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University, Prague, Czechia
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Thomas Behrens
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University, Bochum, Germany
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University, Bochum, Germany
| | - Benjamin Kendzia
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University, Bochum, Germany
| | - Dario Consonni
- Epidemiology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paul A. Demers
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada
| | - Eleonóra Fabiánová
- Regional Authority of Public Health, Banská Bystrica, Slovakia
- Faculty of Health, Catholic University, Ružomberok, Slovakia
| | - Guillermo Fernández-Tardón
- Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
- Health Research Institute of Asturias, University Institute of Oncology of Asturias – Cajastur Social Program, University of Oviedo, Oviedo, Spain
| | - John K. Field
- Roy Castle Lung Cancer Research Programme, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, United Kingdom
| | | | | | - Pascal Guénel
- Center for Research in Epidemiology and Population Health, Team Exposome and Heredity, U1018 Institut national de la santé et de la recherche médicale, University of Paris-Saclay, Villejuif, France
| | - Per Gustavsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen, Germany
| | - Stefan Karrasch
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, and
- Comprehensive Pneumology Center Munich, Member of the German Center for Lung Research, Munich, Germany
- Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg, Germany
| | - Maria Teresa Landi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Jolanta Lissowska
- Epidemiology Unit, Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Christine Barul
- Université Rennes, Institut national de la santé et de la recherche médicale, École des hautes études en santé publique, Institut de recherche en santé, environnement et travail, UMR_S 1085, Pointe-à-Pitre, France
| | - Dana Mates
- National Institute of Public Health, Bucharest, Romania
| | - John R. McLaughlin
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Franco Merletti
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Enrica Migliore
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | | | - Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
| | - Jack Siemiatycki
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Beata Świątkowska
- Department of Environmental Epidemiology, The Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Heinz-Erich Wichmann
- Institut für Medizinische Informatik Biometrie Epidemiologie, Ludwig-Maximilians-Universität München, Munich, Germany
- Comprehensive Pneumology Center Munich, Member of the German Center for Lung Research, Munich, Germany
| | - David Zaridze
- Department of Cancer Epidemiology and Prevention, N.N. Blokhin National Research Center of Oncology, Moscow, Russia
| | - Calvin Ge
- Nederlandse Organisatie voor Toegepast Natuurwetenschappelijk Onderzoek, Utrecht, the Netherlands
| | - Kurt Straif
- ISGlobal, Barcelona, Spain; and
- Boston College, Boston, Massachusetts
| | - Hans Kromhout
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
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Babigumira R, Veierød MB, Hosgood HD, Samuelsen SO, Bråtveit M, Kirkeleit J, Rothman N, Lan Q, Silverman DT, Friesen MC, Shala NK, Grimsrud TK, Stenehjem JS. Benzene exposure and risk of lung cancer in the Norwegian Offshore Petroleum Worker cohort: a prospective case-cohort study. Occup Environ Med 2023:oemed-2023-109139. [PMID: 38154914 DOI: 10.1136/oemed-2023-109139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/11/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVE The objective of our study was to examine whether occupational exposure to benzene is associated with lung cancer among males in the Norwegian Offshore Petroleum Workers cohort. METHODS Among 25 347 male offshore workers employed during 1965-1998, we conducted a case-cohort study with 399 lung cancer cases diagnosed between 1999 and 2021, and 2035 non-cases sampled randomly by 5-year birth cohorts. Individual work histories were coupled to study-specific job-exposure matrices for benzene and other known lung carcinogens. Weighted Cox regression was used to estimate HRs and 95% CIs for the associations between benzene exposure and lung cancer, by major histological subtypes, adjusted for age, smoking and occupational exposure to welding fumes, asbestos and crystalline silica. Missing data were imputed. RESULTS For lung cancer (all subtypes combined), HRs (95% CIs) for the highest quartiles of benzene exposure versus unexposed were 1.15 (0.61 to 2.35) for cumulative exposure, 1.43 (0.76 to 2.69) for duration, and 1.22 (0.68 to 2.18) for average intensity (0.280≤P-trend≤0.741). For 152 adenocarcinoma cases, a positive trend was observed for exposure duration (P-trend=0.044). CONCLUSIONS In this cohort of offshore petroleum workers generally exposed to low average levels of benzene, we did not find an overall clear support for an association with lung cancer (all subtypes combined), although an association was suggested for duration of benzene exposure and adenocarcinoma. The limited evidence might be due to restricted statistical power.
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Affiliation(s)
- Ronnie Babigumira
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo Faculty of Medicine, Oslo, Norway
| | - Marit B Veierød
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo Faculty of Medicine, Oslo, Norway
| | - H Dean Hosgood
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Magne Bråtveit
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Jorunn Kirkeleit
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health (NIOH), Oslo, Norway
| | - Nathaniel Rothman
- Occupational and Environmental Epidemiology, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Qing Lan
- Occupational and Environmental Epidemiology, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Debra T Silverman
- Occupational and Environmental Epidemiology, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Melissa C Friesen
- Occupational and Environmental Epidemiology, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Nita Kaupang Shala
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo Faculty of Medicine, Oslo, Norway
| | - Tom K Grimsrud
- Department of Research, Cancer Registry of Norway, Oslo, Norway
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5
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Moura-Corrêa MJ. Leukemia Mortality among Benzene-Exposed Workers in Brazil (2006-2011). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6314. [PMID: 37444161 PMCID: PMC10341328 DOI: 10.3390/ijerph20136314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/24/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND In this study, the annual leukemia mortality rate is estimated by occupational groups potentially exposed to benzene in Brazil and compared to non-exposed workers by sex. METHODS Data were extracted from the Mortality Information System and the National Institute of Geography and Statistics from 2006 to 2011. Occupational groups exposed to benzene were defined by using the Finnish Job-Exposure Matrix, FINJEM. RESULTS We found 21,049 leukemia deaths in 1917 in occupational groups potentially exposed to benzene, corresponding to an annual average mortality rate of 4.5/100,000, higher than the estimate for non-exposed workers: 2.6/100,000, corresponding to a Mortality rate ratio MRR = 1.7. Each benzene-exposed occupational group had increased leukemia mortality, and printers and occupations in graphics presented the highest MRR (2.7), followed by laboratory assistants (MRR = 2.6), laundry workers, chemists, and upholsterers, each of these occupational groups presenting MRR = 2.3. CONCLUSIONS Benzene shows the need for better enforcement of protective norms against this known carcinogen. Our results support the need for better enforcement of protective norms to reduce benzene exposure.
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Affiliation(s)
- Maria Juliana Moura-Corrêa
- Department of Environmental Health Surveillance and Occupational Health, Health and Environmental Surveillance Secretariat, Ministry of Health (DSAST/SVSA/MS), SRTVN 701, Via W5 Norte, Brasilia 70719-040, Brazil
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6
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Holland R, Khan MAH, Matthews JC, Bonifacio S, Walters R, Koria P, Clowes J, Rodgers K, Jones T, Patel L, Cross R, Sandberg F, Shallcross DE. Investigating the Variation of Benzene and 1,3-Butadiene in the UK during 2000-2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11904. [PMID: 36231204 PMCID: PMC9564389 DOI: 10.3390/ijerph191911904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/10/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
The concentrations of benzene and 1,3-butadiene in urban, suburban, and rural sites of the U.K. were investigated across 20 years (2000-2020) to assess the impacts of pollution control strategies. Given the known toxicity of these pollutants, it is necessary to investigate national long-term trends across a range of site types. We conclude that whilst legislative intervention has been successful in reducing benzene and 1,3-butadiene pollution from vehicular sources, previously overlooked sources must now be considered as they begin to dominate in contribution to ambient pollution. Benzene concentrations in urban areas were found to be ~5-fold greater than those in rural areas, whilst 1,3-butadiene concentrations were up to ~10-fold greater. The seasonal variation of pollutant concentration exhibited a maximum in the winter and a minimum in the summer with summer: winter ratios of 1:2.5 and 1:1.6 for benzene and 1,3-butadiene, respectively. Across the period investigated (2000-2020), the concentrations of benzene decreased by 85% and 1,3-butadiene concentrations by 91%. A notable difference could be seen between the two decades studied (2000-2010, 2010-2020) with a significantly greater drop evident in the first decade than in the second, proving, whilst previously successful, legislative interventions are no longer sufficiently limiting ambient concentrations of these pollutants. The health impacts of these pollutants are discussed, and cancer impact indices were utilized allowing estimation of cancer impacts across the past 20 years for different site types. Those particularly vulnerable to the adverse health effects of benzene and 1,3-butadiene pollution are discussed.
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Affiliation(s)
- Rayne Holland
- School of Chemistry, University of Bristol, Bristol BS8 1TS, UK
| | | | | | | | - Rhian Walters
- School of Chemistry, University of Bristol, Bristol BS8 1TS, UK
| | - Priya Koria
- School of Chemistry, University of Bristol, Bristol BS8 1TS, UK
| | - Joanna Clowes
- School of Chemistry, University of Bristol, Bristol BS8 1TS, UK
| | - Karla Rodgers
- School of Chemistry, University of Bristol, Bristol BS8 1TS, UK
| | - Temi Jones
- School of Chemistry, University of Bristol, Bristol BS8 1TS, UK
| | - Leeya Patel
- School of Chemistry, University of Bristol, Bristol BS8 1TS, UK
| | - Rhianna Cross
- School of Chemistry, University of Bristol, Bristol BS8 1TS, UK
| | - Freya Sandberg
- School of Chemistry, University of Bristol, Bristol BS8 1TS, UK
| | - Dudley E. Shallcross
- School of Chemistry, University of Bristol, Bristol BS8 1TS, UK
- Department Chemistry, University of the Western Cape, Robert Sobukwe Road, Bellville 7535, South Africa
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7
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Bukhari S, Siddique MH, Naeem A, Khan I, Ali Z, Essa A, Fazal F, Anis RA, Moran L, Sultan A, Murtaza I, Vanhara P, Anees M. Combined efficacy of Cinnamomum zeylanicum and doxorubicin against leukemia through regulation of TRAIL and NF-kappa B pathways in rat model. Mol Biol Rep 2022; 49:6495-6507. [PMID: 35579734 DOI: 10.1007/s11033-022-07478-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 04/14/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Recent discoveries in cancer therapeutics have proven combination therapies more effective than individual drugs. This study describes the efficacy of the combination of Cinnamomum zeylanicum and doxorubicin against benzene-induced leukemia. METHODS AND RESULTS Brine shrimp assay was used to assess the cytotoxicity of C. zeylanicum, doxorubicin and their combination. After AML induction in Sprague Dawley rats, the same drugs were given to rat groups. Changes in organ weight, haematological profile, and hepatic enzymes were determined. Real-time PCR was used to elucidate the effect on the expression of STMN1, GAPDH, P53 and various TRAIL and NF-kappaB components. C. zeylanicum reduced the cytotoxicity of doxorubicin. The combination treatment showed better anti-leukemic results than any of the individual drugs as evident from STMN1 expression (p < 0.001). It was particularly effective in reducing total white blood cell counts and recovering lymphocytes, monocytes and eosinophils along with hepatic enzymes ALT and AST (p < 0.001). All doses recovered relative organ weights and improved blood parameters. The combination therapy was particularly effective in inducing apoptosis, inhibition of proliferation marker GAPDH (p < 0.001) and NF-kappaB pathway components Rel-A (p < 0.001) and Rel-B (p < 0.01). Expressions of TRAIL components c-FLIP (p < 0.001), TRAIL ligand (p < 0.001) and caspase 8 (p < 0.01) were also altered. CONCLUSION Cinnamomum zeylanicum in combination with doxorubicin helps to counter benzene-induced cellular and hepatic toxicity and improves haematological profile. The anti-leukemic effects are potentially due to inhibition of GAPDH and NF-kappa B pathway, and through regulation of TRAIL pathway. Our data suggests the use of C. zeylanicum with doxorubicin to improve anti-leukemic therapeutic regimes.
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Affiliation(s)
- Sidra Bukhari
- Department of Biochemistry, Quaid-i-Azam University, Islamabad, 45320, Pakistan
| | | | - Anum Naeem
- Department of Biochemistry, Quaid-i-Azam University, Islamabad, 45320, Pakistan
| | - InamUllah Khan
- Department of Biochemistry, Quaid-i-Azam University, Islamabad, 45320, Pakistan
| | - Zain Ali
- Department of Biochemistry, Quaid-i-Azam University, Islamabad, 45320, Pakistan
| | - Asiya Essa
- Department of Biochemistry, Quaid-i-Azam University, Islamabad, 45320, Pakistan
| | - Falak Fazal
- Department of Biochemistry, Quaid-i-Azam University, Islamabad, 45320, Pakistan
| | - Riffat Aysha Anis
- Department of Diet and Nutritional Sciences, Ibadat International University, Islamabad, Pakistan
| | - Lukas Moran
- Department of Histology and Embryology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Aneesa Sultan
- Department of Biochemistry, Quaid-i-Azam University, Islamabad, 45320, Pakistan
| | - Iram Murtaza
- Department of Biochemistry, Quaid-i-Azam University, Islamabad, 45320, Pakistan
| | - Petr Vanhara
- Department of Histology and Embryology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Mariam Anees
- Department of Biochemistry, Quaid-i-Azam University, Islamabad, 45320, Pakistan.
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8
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Rana I, Dahlberg S, Steinmaus C, Zhang L. Benzene exposure and non-Hodgkin lymphoma: a systematic review and meta-analysis of human studies. Lancet Planet Health 2021; 5:e633-e643. [PMID: 34450064 PMCID: PMC9109598 DOI: 10.1016/s2542-5196(21)00149-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 05/18/2021] [Accepted: 05/27/2021] [Indexed: 05/07/2023]
Abstract
BACKGROUND Non-Hodgkin lymphoma comprises a heterogeneous group of cancers with unresolved aetiology, although risk factors include environmental exposures to toxic chemicals. Although the ubiquitous pollutant benzene is an established leukemogen, its potential to cause non-Hodgkin lymphoma has been widely debated. We aimed to examine the potential link between benzene exposure and risk of non-Hodgkin lymphoma in humans by evaluating a wide array of cohort and case-control studies using electronic systematic review. METHODS We did a comprehensive systematic review and meta-analysis of all qualified human epidemiological studies that assessed the relationship between benzene exposure and non-Hodgkin lymphoma. We queried the PubMed and Embase databases for relevant articles published before June 5, 2019, and applied the SysRev platform for study selection. All peer-reviewed human cohort and case-control studies that reported non-Hodgkin lymphoma risk estimates specifically for benzene exposure were eligible for inclusion. Studies that calculated relative risks (RRs) for industries or job types without identifying those specifically exposed to benzene, that combined non-Hodgkin lymphoma with other cancer types, or that reported many different solvent exposures together were excluded. From each study, two investigators independently extracted information on the study design, location, years, sample size, participation rates, age, sex, sources of cases and controls, diagnosis, histological verification, exposure assessment, results, adjustment, and statistical analysis, and subsequently assessed study quality. We calculated the meta-analysis relative risk (meta-RR) and CIs using the fixed effect and random effect models, as well as assessing publication bias. FINDINGS Our search yielded 2481 articles. After screening and removal of duplicates, 20 case-control studies and eight cohort studies were included in our meta-analysis, which included a total of 9587 patients with non-Hodgkin lymphoma. We reported an increased meta-relative risk (meta-RR) of 33% in highly exposed groups, when data were available (meta-RR 1·33 [95% CI 1·13-1·57], n=28). The meta-RR rose to 1·51 (1·22-1·87, n=18) in the studies that provided results specifically for highly exposed individuals. In particular, we reported a doubling of this risk for diffuse large B-cell lymphoma, a major non-Hodgkin lymphoma subtype (1·67 [1·01-2·77]). We also detected increased risks for follicular lymphoma (1·47 [0·95-2·27]) and hairy cell leukaemia (1·77 [0·99-3·16]), though they were not statistically significant. Funnel plot, Egger's test (p=0·77) and Begg's test (p=0·98) did not show evidence of publication bias. We evaluated the major aspects of causal inference and found evidence to support all the Hill considerations for assigning causation. INTERPRETATION Our findings suggest a causal link between benzene exposure and non-Hodgkin lymphoma, especially for diffuse large B-cell lymphoma. FUNDING National Institute of Environmental Health Sciences.
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Affiliation(s)
- Iemaan Rana
- Division of Environmental Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Sarah Dahlberg
- Division of Environmental Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Craig Steinmaus
- Division of Environmental Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, USA; Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Luoping Zhang
- Division of Environmental Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, USA.
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Virji MA, Kurth L. Peak Inhalation Exposure Metrics Used in Occupational Epidemiologic and Exposure Studies. Front Public Health 2021; 8:611693. [PMID: 33490023 PMCID: PMC7820770 DOI: 10.3389/fpubh.2020.611693] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 12/07/2020] [Indexed: 12/24/2022] Open
Abstract
Peak exposures are of concern because they can potentially overwhelm normal defense mechanisms and induce adverse health effects. Metrics of peak exposure have been used in epidemiologic and exposure studies, but consensus is lacking on its definition. The relevant characteristics of peak exposure are dependent upon exposure patterns, biokinetics of exposure, and disease mechanisms. The objective of this review was to summarize the use of peak metrics in epidemiologic and exposure studies. A comprehensive search of Medline, Embase, Web of Science, and NIOSHTIC-2 databases was conducted using keywords related to peak exposures. The retrieved references were reviewed and selected for indexing if they included a peak metric and met additional criteria. Information on health outcomes and peak exposure metrics was extracted from each reference. A total of 1,215 epidemiologic or exposure references were identified, of which 182 were indexed and summarized. For the 72 epidemiologic studies, the health outcomes most frequently evaluated were: chronic respiratory effects, cancer and acute respiratory symptoms. Exposures were frequently assessed using task-based and full-shift time-integrated methods, qualitative methods, and real-time instruments. Peak exposure summary metrics included the presence or absence of a peak event, highest exposure intensity and frequency greater than a target. Peak metrics in the 110 exposure studies most frequently included highest exposure intensity, average short-duration intensity, and graphical presentation of the real-time data (plots). This review provides a framework for considering biologically relevant peak exposure metrics for epidemiologic and exposure studies to help inform risk assessment and exposure mitigation.
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Affiliation(s)
- M Abbas Virji
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, United States
| | - Laura Kurth
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, United States
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10
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Key event-informed risk models for benzene-induced acute myeloid leukaemia. Toxicol Lett 2021; 340:141-152. [PMID: 33429013 DOI: 10.1016/j.toxlet.2021.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 12/10/2020] [Accepted: 01/04/2021] [Indexed: 11/20/2022]
Abstract
Occupational exposure to benzene at levels of 10 ppm or more has been associated with increased risk of acute myeloid leukaemia (AML). The mode of action (MOA) for AML development leading to mortality is anticipated to include multiple earlier key events, which can be observed in hematotoxicity and genetic toxicity in peripheral blood of exposed workers. Prevention of these early events would lead to prevention of the apical, adverse outcomes, the morbidity and mortality caused by the myelodysplastic syndromes (MDS) and AML. Incorporation of key event information should modify the risk model, but few modification approaches have been suggested. To that end, two approaches to risk model modification are described that use sub-linear and segmented linear increases in risk below key events, while maintaining a linear increase in AML mortality risk beginning at 2 ppm, the lowest observed adverse effect concentration (LOAEC) identified for hemato- and geno- toxicity in high quality studies of human occupational exposure. Below 2 ppm two different modification approaches to quantitative risk models were applied: a continuously decreasing slope model and a segmented modification in slope. These two approaches provide greater flexibility to incorporate MOA information in risk model development and selection.
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11
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Linet MS, Gilbert ES, Vermeulen R, Dores GM, Yin SN, Portengen L, Hayes RB, Ji BT, Lan Q, Li GL, Rothman N. Benzene exposure-response and risk of lymphoid neoplasms in Chinese workers: A multicenter case-cohort study. Am J Ind Med 2020; 63:741-754. [PMID: 32474961 PMCID: PMC10986157 DOI: 10.1002/ajim.23142] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 05/15/2020] [Accepted: 05/18/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND While international agreement supports a causal relationship of benzene exposure with acute myeloid leukemia, there is debate about benzene and lymphoid neoplasm risks. METHODS In a case-cohort study with follow-up of 110 631 Chinese workers during 1972-1999, we evaluated benzene exposure-response for non-Hodgkin lymphoma (NHL), lymphoid leukemias (LL), acute lymphocytic leukemia (ALL), and total lymphoid neoplasms (LN). We estimated benzene exposures using state-of-the-art hierarchical modeling of occupational factors calibrated with historical routine measurements and evaluated cumulative exposure-response using Cox regression. RESULTS NHL and other specified LN were increased in exposed vs unexposed workers. However, there was no evidence of exposure-response for NHL or other specified LN. Based on a linear exposure-response, relative risks at 100 parts per million-years (RR at 100 ppm-years) for cumulative benzene exposure using a 2-year lag (exposure at least 2 years before the time at risk) were 1.05 for NHL (95 percent confidence interval (CI) = 0.97, 1.27; 32 cases), 1.11 for LL (95% CI < 0, 1.66; 12 cases), 1.21 for ALL (95% CI < 0, 3.53; 10 cases), and 1.02 for total LN (95% CI < 0, 1.16; 49 cases). No statistically significant exposure-response trends were apparent for these LN for 2 to <10-year or ≥10-year lags. NHL risks were not significantly modified by sex, age, or year at first exposure, attained age, or time since exposure. CONCLUSION Given the study strengths and limitations, we found little evidence of exposure-response for benzene and NHL, LL, ALL, or total LN, although NHL and other specified LN were increased in exposed vs unexposed individuals.
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Affiliation(s)
- Martha S. Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, USA
| | - Ethel S. Gilbert
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, USA
| | - Roel Vermeulen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Graça M. Dores
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, USA
- Analytic Epidemiology Branch, Division of Epidemiology, Office of Biostatistics and Epidemiology, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Song-Nian Yin
- National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, 29 Nan Wei Road, Beijing, Peoples Republic of China
| | - Lutzen Portengen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Richard B. Hayes
- Division of Epidemiology, Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Bu-Tian Ji
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, USA
| | - Qing Lan
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, USA
| | - Gui-Lan Li
- National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, 29 Nan Wei Road, Beijing, Peoples Republic of China
| | - Nathaniel Rothman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, USA
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12
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A clandestine culprit with critical consequences: Benzene and acute myeloid leukemia. Blood Rev 2020; 47:100736. [PMID: 32771228 DOI: 10.1016/j.blre.2020.100736] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/17/2020] [Accepted: 07/14/2020] [Indexed: 12/20/2022]
Abstract
While most clinicians recognize adult therapy-related leukemias following cytotoxic chemotherapy and radiation, environmental regulatory agencies evaluate exposure to "safe levels" of leukemogenic compounds. Benzene represents the most notorious leukemogenic chemical. Used in the production of ubiquitous items such as plastics, lubricants, rubbers, dyes, and pesticides, benzene may be responsible for the higher risk of acute myeloid leukemia (AML) among automobile, janitorial, construction, and agricultural workers. It is possible that ambient benzene may contribute to many cases of "de novo" AML not arising out of germline predispositions. In this appraisal of the available literature, we evaluate and discuss the association between chronic, low-dose and ambient exposure to environmental benzene and the development of adult AML.
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13
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Linet MS, Gilbert ES, Vermeulen R, Dores GM, Yin SN, Portengen L, Hayes RB, Ji BT, Lan Q, Li GL, Rothman N. Benzene Exposure Response and Risk of Myeloid Neoplasms in Chinese Workers: A Multicenter Case-Cohort Study. J Natl Cancer Inst 2020; 111:465-474. [PMID: 30520970 DOI: 10.1093/jnci/djy143] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 06/21/2018] [Accepted: 07/17/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND There is international consensus that benzene exposure is causally related to acute myeloid leukemia (AML), and more recent evidence of association with myelodysplastic syndromes (MDS). However, there are uncertainties about the exposure response, particularly risks by time since exposure and age at exposure. METHODS In a case-cohort study in 110 631 Chinese workers followed up during 1972-1999 we evaluated combined MDS/AML (n = 44) and chronic myeloid leukemia (n = 18). We estimated benzene exposures using hierarchical modeling of occupational factors calibrated with historical routine measurements, and evaluated exposure response for cumulative exposure and average intensity using Cox regression; P values were two-sided. RESULTS Increased MDS/AML risk with increasing cumulative exposure in our a priori defined time window (2 to <10 years) before the time at risk was suggested (Ptrend = 08). For first exposure (within the 2 to <10-year window) before age 30 years, the exposure response was stronger (P = .004) with rate ratios of 1.12 (95% confidence interval [CI] = 0.27 to 4.29), 5.58 (95% CI = 1.65 to 19.68), and 4.50 (95% CI = 1.22 to 16.68) for cumulative exposures of more than 0 to less than 40, 40 to less than 100, and at least 100 ppm-years, respectively, compared with no exposure. There was little evidence of exposure response after at least 10 years (Ptrend = .94), regardless of age at first exposure. Average intensity results were generally similar. The risk for chronic myeloid leukemia was increased in exposed vs unexposed workers, but appeared to increase and then decrease with increasing exposure. CONCLUSION For myeloid neoplasms, the strongest effects were apparent for MDS/AML arising within 10 years of benzene exposure and for first exposure in the 2 to less than 10-year window before age 30 years.
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Affiliation(s)
- Martha S Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD
| | - Ethel S Gilbert
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD
| | - Roel Vermeulen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Graça M Dores
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD
| | - Song-Nian Yin
- National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, Peoples Republic of China
| | - Lutzen Portengen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Richard B Hayes
- Division of Epidemiology, Department of Population Health, New York University School of Medicine, New York, NY
| | - Bu-Tian Ji
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD
| | - Qing Lan
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD
| | - Gui-Lan Li
- National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, Peoples Republic of China
| | - Nathaniel Rothman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD
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Checkoway H, Lees PSJ, Dell LD, Gentry PR, Mundt KA. Peak Exposures in Epidemiologic Studies and Cancer Risks: Considerations for Regulatory Risk Assessment. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2019; 39:1441-1464. [PMID: 30925210 PMCID: PMC6850123 DOI: 10.1111/risa.13294] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 12/22/2018] [Accepted: 12/24/2018] [Indexed: 05/20/2023]
Abstract
We review approaches for characterizing "peak" exposures in epidemiologic studies and methods for incorporating peak exposure metrics in dose-response assessments that contribute to risk assessment. The focus was on potential etiologic relations between environmental chemical exposures and cancer risks. We searched the epidemiologic literature on environmental chemicals classified as carcinogens in which cancer risks were described in relation to "peak" exposures. These articles were evaluated to identify some of the challenges associated with defining and describing cancer risks in relation to peak exposures. We found that definitions of peak exposure varied considerably across studies. Of nine chemical agents included in our review of peak exposure, six had epidemiologic data used by the U.S. Environmental Protection Agency (US EPA) in dose-response assessments to derive inhalation unit risk values. These were benzene, formaldehyde, styrene, trichloroethylene, acrylonitrile, and ethylene oxide. All derived unit risks relied on cumulative exposure for dose-response estimation and none, to our knowledge, considered peak exposure metrics. This is not surprising, given the historical linear no-threshold default model (generally based on cumulative exposure) used in regulatory risk assessments. With newly proposed US EPA rule language, fuller consideration of alternative exposure and dose-response metrics will be supported. "Peak" exposure has not been consistently defined and rarely has been evaluated in epidemiologic studies of cancer risks. We recommend developing uniform definitions of "peak" exposure to facilitate fuller evaluation of dose response for environmental chemicals and cancer risks, especially where mechanistic understanding indicates that the dose response is unlikely linear and that short-term high-intensity exposures increase risk.
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Affiliation(s)
- Harvey Checkoway
- Department of Family Medicine & Public HealthSan Diego School of Medicine, University of CaliforniaLa JollaCAUSA
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15
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Edokpolo B, Yu QJ, Connell D. Use of toxicant sensitivity distributions (TSD) for development of exposure guidelines for risk to human health from benzene. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 250:386-396. [PMID: 31022644 DOI: 10.1016/j.envpol.2019.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 03/29/2019] [Accepted: 04/01/2019] [Indexed: 06/09/2023]
Abstract
This technique for setting guideline values differs from that currently used by regulatory agencies throughout the world. Data for benzene were evaluated from epidemiological studies on human populations (29 studies). Exposure durations were evaluated in terms of Long Term Exposure (LTE) and Lifetime Exposure. All data was reported as Lowest Observed Adverse Effect Levels (LOAEL) and converted into exposure doses using Average Daily Dose (ADD) and Lifetime Average Daily Dose (LADD). These values were plotted as a Toxicant Sensitivity Distribution (TSD) which was the cumulative probability of LOAEL-ADD and LOAEL-LADD. From the TSD plots, linear regression equations gave correlation coefficients (R2) ranging from 0.69 to 0.97 indicating normal distributions. Guideline Values (GVs) for LTE (8hr/day) and Lifetime (24hr/70yrs) exposure to benzene were calculated using data from human epidemiological studies as 5% level of cumulative probability (CP) of LOAEL-ADD and LOAEL-LADD from the cumulative probability distributions (CPD). The derived guideline values from the human epidemiological studies were 92 μg/kg/day for LTE and 3.4 μg/kg/day for lifetime exposure. GV for LTE is appropriate for occupational exposure and GV derived for lifetime exposure appropriate for the general population. The guideline value for occupational exposure limit was below all the guideline values developed by regulatory agencies. But the general population guideline is within the range of values formulated by European Union, ATSDR, EPAQS, USEPA and OEHHA for air quality for the general population. This is an alternative method which eliminates the application of safety factors and other sources of errors in deriving guideline values for benzene.
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Affiliation(s)
- Benjamin Edokpolo
- School of Engineering and Built Environment, Griffith University, Nathan Campus, Brisbane, 4111, QLD, Australia
| | - Qiming Jimmy Yu
- School of Engineering and Built Environment, Griffith University, Nathan Campus, Brisbane, 4111, QLD, Australia.
| | - Des Connell
- School of Environment and Sciences, Griffith University, Nathan Campus, Brisbane, 4111, QLD, Australia
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Warden H, Richardson H, Richardson L, Siemiatycki J, Ho V. Associations between occupational exposure to benzene, toluene and xylene and risk of lung cancer in Montréal. Occup Environ Med 2018; 75:696-702. [PMID: 29764994 DOI: 10.1136/oemed-2017-104987] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 04/18/2018] [Accepted: 04/28/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND Benzene, toluene and xylene (BTX) are aromatic hydrocarbons with inconclusive evidence of lung carcinogenicity. The aim of this research was to assess the associations between occupational exposures to BTX agents and lung cancer. METHODS In a population-based case-control study of lung cancer, occupational histories were obtained and exposures were assessed by experts. Unconditional multivariate logistic regression was used to estimate ORs and 95% CIs, among men, between various metrics of occupational exposure to BTX and lung cancer, while adjusting for established and possible risk factors. RESULTS Considerable overlap was found between occupational exposure to BTX, where the majority of exposed participants were exposed to all three chemicals. Lung cancer was associated with exposure to benzene (OR=1.35; 95% CI 0.99 to 1.84), toluene (OR=1.31; 95% CI 0.99 to 1.74) and xylene (OR=1.44; 95% CI 1.03 to 2.01). While these results were adjusted for smoking and other recognised and possible lung cancer risk factors, they were not mutually adjusted among the three BTX agents. CONCLUSIONS Our study provides suggestive evidence that occupational exposure to one or more of the BTX agents may be associated with lung cancer.
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Affiliation(s)
- Hunter Warden
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Harriet Richardson
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Lesley Richardson
- University of Montréal Hospital Research Centre (CRCHUM), Health Innovation and Evaluation Hub, Montréal, Québec, Canada
| | - Jack Siemiatycki
- University of Montréal Hospital Research Centre (CRCHUM), Health Innovation and Evaluation Hub, Montréal, Québec, Canada.,Department of Social and Preventive Medicine, University of Montréal, Montréal, Québec, Canada
| | - Vikki Ho
- University of Montréal Hospital Research Centre (CRCHUM), Health Innovation and Evaluation Hub, Montréal, Québec, Canada.,Department of Social and Preventive Medicine, University of Montréal, Montréal, Québec, Canada
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Makoś P, Fernandes A, Boczkaj G. Method for the simultaneous determination of monoaromatic and polycyclic aromatic hydrocarbons in industrial effluents using dispersive liquid-liquid microextraction with gas chromatography-mass spectrometry. J Sep Sci 2018; 41:2360-2367. [DOI: 10.1002/jssc.201701464] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 02/13/2018] [Accepted: 02/15/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Patrycja Makoś
- Faculty of Chemistry; Department of Chemical and Process Engineering; Gdansk University of Technology; Gdansk Poland
| | - André Fernandes
- Faculty of Chemistry; Department of Chemical and Process Engineering; Gdansk University of Technology; Gdansk Poland
| | - Grzegorz Boczkaj
- Faculty of Chemistry; Department of Chemical and Process Engineering; Gdansk University of Technology; Gdansk Poland
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Tuomi T, Veijalainen H, Santonen T. Managing Exposure to Benzene and Total Petroleum Hydrocarbons at Two Oil Refineries 1977-2014. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020197. [PMID: 29364857 PMCID: PMC5858266 DOI: 10.3390/ijerph15020197] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 01/15/2018] [Accepted: 01/18/2018] [Indexed: 11/16/2022]
Abstract
Air concentrations of and inhalation exposure to total petroleum hydrocarbons (TPH) and benzene was monitored separately at two oil refineries from 1977 to 2014. Prevention policies and control measures that may explain changes were surveyed. The aim was to evaluate how the application of of Occupational Health and Safety Assessment Series OHSAS 18001.04 principles as well as Environmental protection Agency EPA and European Oil Company Organisation for Environment, Health and Safety CONCAWE practices have influenced air concentrations. Benzene air concentrations declined in 11 of 17 units, six of which were associated with declining exposures. Benzene air concentrations declined across all units on average by 46%. This amounts to an average yearly decline of 1.7%. TPH air concentrations declined in 10 of 17 units, seven of which were associated with declining exposures. The average decline in TPH air concentrations was 49%, corresponding to 1.3% per year. As a result, average working day exposure in 10 of 17 units have declined significantly and today, benzene and TPH exposure in most units are well below 10% of the current Occupational Exposure Limit (OEL8h:s). A decline in air concentrations have coincided with consistent implementation of control measures. Such measures include on-line monitoring of leaks; benzene recovery; floating container roofs; improved valves and seals; hermetic pumps; recovery of loading gases and instalment of torches in terminals; cutback in coke combustion; a new production line spanning directly from the dock to aromatics production; and recovery of loading gases in the doc. Other tools in exposure management include personal leak monitors, on-line measurements, monitoring campaigns, risk assessment, and availability and user training of protective equipment. However, improvements are still needed. Hydrocarbon or benzene air concentrations have not declined in 8 of 17 units, in some of which concentrations exceed 10% of the relevant OEL8h value. In addition, for benzene even 10% of the current OEL, 0.1 ppm, might still possess a risk. With this in mind, methods to estimate exposure at the refineries need to be improved to enable measuring benzene concentrations <0.1 ppm. Shut downs of the refinery have been associated with peaks in exposure concentrations. Consequently, effort should be placed on safe working methods pertaining to shutdowns. Also, the connection and detachment of hoses continues to be problematic from the point of view of controlling exposure.
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Affiliation(s)
- Tapani Tuomi
- Finnish Institute of Occupational Health (FIOH), Topeliuksenkatu 41 B, P.O. Box 40, Työterveyslaitos, FI-00032 Helsinki, Finland.
| | - Henna Veijalainen
- Finnish Institute of Occupational Health (FIOH), Topeliuksenkatu 41 B, P.O. Box 40, Työterveyslaitos, FI-00032 Helsinki, Finland.
| | - Tiina Santonen
- Finnish Institute of Occupational Health (FIOH), Topeliuksenkatu 41 B, P.O. Box 40, Työterveyslaitos, FI-00032 Helsinki, Finland.
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Costa C, Miozzi E, Teodoro M, Briguglio G, Rapisarda V, Fenga C. New insights on 'old' toxicants in occupational toxicology (Review). Mol Med Rep 2017; 15:3317-3322. [PMID: 28339055 DOI: 10.3892/mmr.2017.6374] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 02/09/2017] [Indexed: 11/06/2022] Open
Abstract
In order to deliver the best possible working environment, it is essential to identify professional conditions that could be harmful for worker's health and prevent (or limit) the occurrence of such conditions. The appropriate use of personal protective equipment and the development of appropriate regulations allowed to reduce the prevalence of 'classic' occupational diseases, such as occupational hearing loss or asbestosis, just to name a few. Nowadays, environmental pollution seems to be one of the most relevant concerns for human and animal health, and toxicology is becoming one of the most prominent fields of interest in occupational settings. An increasing number of studies demonstrate that the presence of toxicants in the workplace could be responsible for the development of chronic diseases, even at doses that were considered 'safe'. The present review summarizes some of the most recent advancements in occupational toxicology, focusing on topics that have long been debated in the past and that have recently returned to the fore.
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Affiliation(s)
- Chiara Costa
- Department of Clinical and Experimental Medicine, University of Messina, Policlinico 'G. Martino', I‑98125 Messina, Italy
| | - Edoardo Miozzi
- Section of Occupational Medicine, Department of Biomedical, Odontoiatric, Morphological and Functional Images, University of Messina, Policlinico 'G. Martino', I‑98125 Messina, Italy
| | - Michele Teodoro
- Section of Occupational Medicine, Department of Biomedical, Odontoiatric, Morphological and Functional Images, University of Messina, Policlinico 'G. Martino', I‑98125 Messina, Italy
| | - Giusi Briguglio
- Section of Occupational Medicine, Department of Biomedical, Odontoiatric, Morphological and Functional Images, University of Messina, Policlinico 'G. Martino', I‑98125 Messina, Italy
| | - Venerando Rapisarda
- Section of Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, I‑95124 Catania, Italy
| | - Concettina Fenga
- Section of Occupational Medicine, Department of Biomedical, Odontoiatric, Morphological and Functional Images, University of Messina, Policlinico 'G. Martino', I‑98125 Messina, Italy
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Salemi R, Marconi A, Di Salvatore V, Franco S, Rapisarda V, Libra M. Epigenetic alterations and occupational exposure to benzene, fibers, and heavy metals associated with tumor development. Mol Med Rep 2017; 15:3366-3371. [DOI: 10.3892/mmr.2017.6383] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 02/16/2017] [Indexed: 11/05/2022] Open
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Falzone L, Marconi A, Loreto C, Franco S, Spandidos DA, Libra M. Occupational exposure to carcinogens: Benzene, pesticides and fibers (Review). Mol Med Rep 2016; 14:4467-4474. [PMID: 27748850 PMCID: PMC5101963 DOI: 10.3892/mmr.2016.5791] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 09/20/2016] [Indexed: 01/01/2023] Open
Abstract
It is well known that the occupational exposure to contaminants and carcinogens leads to the development of cancer in exposed workers. In the 18th century, Percivall Pott was the first to hypothesize that chronic exposure to dust in the London chimney sweeps was associated with an increased risk of developing cancer. Subsequently a growing body of evidence indicated that other physical factors were also responsible for oncogenic mutations. Over the past decades, many carcinogens have been found in the occupational environment and their presence is often associated with an increased incidence of cancer. Occupational exposure involves several factors and the association between carcinogens, occupational exposure and cancer is still unclear. Only a fraction of factors is recognized as occupational carcinogens and for each factor, there is an increased risk of cancer development associated with a specific work activity. According to the International Agency for Research on Cancer (IARC), the majority of carcinogens are classified as 'probable' and 'possible' human carcinogens, while, direct evidence of carcinogenicity is provided in epidemiological and experimental studies. In the present review, exposures to benzene, pesticides and mineral fibers are discussed as the most important cancer risk factors during work activities.
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Affiliation(s)
- Luca Falzone
- Department of Biomedical and Biotechnological Sciences, Section of General and Clinical Pathology and Oncology, University of Catania, I-95124 Catania, Italy
| | - Andrea Marconi
- Section of Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, I-95124 Catania, Italy
| | - Carla Loreto
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, I-95124 Catania, Italy
| | - Sabrina Franco
- Department of Medical, Surgical and Advanced Technology Sciences ‘G.F. Ingrassia’, University of Catania, I-95124 Catania, Italy
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, Heraklion 71003, Greece
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, Section of General and Clinical Pathology and Oncology, University of Catania, I-95124 Catania, Italy
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22
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Mattei F, Liverani S, Guida F, Matrat M, Cenée S, Azizi L, Menvielle G, Sanchez M, Pilorget C, Lapôtre-Ledoux B, Luce D, Richardson S, Stücker I. Multidimensional analysis of the effect of occupational exposure to organic solvents on lung cancer risk: the ICARE study. Occup Environ Med 2016; 73:368-77. [PMID: 26911986 PMCID: PMC4893113 DOI: 10.1136/oemed-2015-103177] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 01/22/2016] [Accepted: 02/05/2016] [Indexed: 11/03/2022]
Abstract
BACKGROUND The association between lung cancer and occupational exposure to organic solvents is discussed. Since different solvents are often used simultaneously, it is difficult to assess the role of individual substances. OBJECTIVES The present study is focused on an in-depth investigation of the potential association between lung cancer risk and occupational exposure to a large group of organic solvents, taking into account the well-known risk factors for lung cancer, tobacco smoking and occupational exposure to asbestos. METHODS We analysed data from the Investigation of occupational and environmental causes of respiratory cancers (ICARE) study, a large French population-based case-control study, set up between 2001 and 2007. A total of 2276 male cases and 2780 male controls were interviewed, and long-life occupational history was collected. In order to overcome the analytical difficulties created by multiple correlated exposures, we carried out a novel type of analysis based on Bayesian profile regression. RESULTS After analysis with conventional logistic regression methods, none of the 11 solvents examined were associated with lung cancer risk. Through a profile regression approach, we did not observe any significant association between solvent exposure and lung cancer. However, we identified clusters at high risk that are related to occupations known to be at risk of developing lung cancer, such as painters. CONCLUSIONS Organic solvents do not appear to be substantial contributors to the occupational risk of lung cancer for the occupations known to be at risk.
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Affiliation(s)
- Francesca Mattei
- Université Paris Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - Silvia Liverani
- Department of Mathematics, Brunel University London, Uxbridge, UK
- MRC Biostatistics Unit, Cambridge Institute of Public Health, Cambridge Biomedical Campus, Cambridge, UK
| | - Florence Guida
- Department of Epidemiology and Biostatistics, Imperial College London, MRC-PHE Centre for Environment and Health, School of Public Health, London, UK
| | - Mireille Matrat
- Université Paris Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
- Faculty of Medicine IFR 10, University Paris Est-Créteil, Créteil, France
| | - Sylvie Cenée
- Université Paris Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - Lamiae Azizi
- University of Sydney, Sydney School of Public Health, Screening an Evaluation Test Program, Sydney, New South Wales, Australia
| | - Gwenn Menvielle
- Department of social epidemiology, INSERM, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Villejuif, France
- Department of social epidemiology, Sorbonne University, UPMC University of Paris 06, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Villejuif, France
| | - Marie Sanchez
- Université Paris Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - Corinne Pilorget
- French Institute for Public Health Surveillance, Saint-Maurice, France
- Epidemiological research and surveillance unit in transport, occupation and environment, Claude Bernard Lyon1 University, Lyon, France
| | | | - Danièle Luce
- INSERM, U 1085_IRSET, Pointe-à-Pitre, France
- University of Rennes 1, Rennes, France
| | - Sylvia Richardson
- MRC Biostatistics Unit, Cambridge Institute of Public Health, Cambridge Biomedical Campus, Cambridge, UK
| | - Isabelle Stücker
- Université Paris Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
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Evaluation of Acute Nonlymphocytic Leukemia and Its Subtypes With Updated Benzene Exposure and Mortality Estimates. J Occup Environ Med 2016; 58:414-20. [DOI: 10.1097/jom.0000000000000689] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ning XA, Wang JY, Li RJ, Wen WB, Chen CM, Wang YJ, Yang ZY, Liu JY. Fate of volatile aromatic hydrocarbons in the wastewater from six textile dyeing wastewater treatment plants. CHEMOSPHERE 2015; 136:50-55. [PMID: 25930124 DOI: 10.1016/j.chemosphere.2015.03.086] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 01/30/2015] [Accepted: 03/21/2015] [Indexed: 06/04/2023]
Abstract
The occurrence and removal of benzene, toluene, ethylbenzene, xylenes, styrene and isopropylbenzene (BTEXSI) from 6 textile dyeing wastewater treatment plants (TDWTPs) were investigated in this study. The practical capacities of the 6 representative plants, which used the activated sludge process, ranged from 1200 to 26000 m(3) d(-1). The results indicated that BTEXSI were ubiquitous in the raw textile dyeing wastewater, except for isopropylbenzene, and that toluene and xylenes were predominant in raw wastewaters (RWs). TDWTP-E was selected to study the residual BTEXSI at different stages. The total BTEXSI reduction on the aerobic process of TDWTP-E accounted for 82.2% of the entire process. The total BTEXSI concentrations from the final effluents (FEs) were observed to be below 1 μg L(-1), except for TDWTP-F (2.12 μg L(-1)). Volatilization and biodegradation rather than sludge sorption contributed significantly to BTEXSI removal in the treatment system. BTEXSI were not found to be the main contaminants in textile dyeing wastewater.
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Affiliation(s)
- Xun-An Ning
- School of Environmental Science and Engineering, Guangdong University of Technology, Guangzhou 510006, China.
| | - Jing-Yu Wang
- School of Environmental Science and Engineering, Guangdong University of Technology, Guangzhou 510006, China.
| | - Rui-Jing Li
- School of Environmental Science and Engineering, Guangdong University of Technology, Guangzhou 510006, China
| | - Wei-Bin Wen
- School of Environmental Science and Engineering, Guangdong University of Technology, Guangzhou 510006, China
| | - Chang-Min Chen
- School of Environmental Science and Engineering, Guangdong University of Technology, Guangzhou 510006, China
| | - Yu-Jie Wang
- School of Environmental Science and Engineering, Guangdong University of Technology, Guangzhou 510006, China
| | - Zuo-Yi Yang
- School of Environmental Science and Engineering, Guangdong University of Technology, Guangzhou 510006, China
| | - Jing-Yong Liu
- School of Environmental Science and Engineering, Guangdong University of Technology, Guangzhou 510006, China
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25
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Bassig BA, Friesen MC, Vermeulen R, Shu XO, Purdue MP, Stewart PA, Xiang YB, Chow WH, Zheng T, Ji BT, Yang G, Linet MS, Hu W, Zhang H, Zheng W, Gao YT, Rothman N, Lan Q. Occupational Exposure to Benzene and Non-Hodgkin Lymphoma in a Population-Based Cohort: The Shanghai Women's Health Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2015; 123:971-7. [PMID: 25748391 PMCID: PMC4590744 DOI: 10.1289/ehp.1408307] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 03/04/2015] [Indexed: 05/15/2023]
Abstract
BACKGROUND The association between benzene exposure and non-Hodgkin lymphoma (NHL) has been the subject of debate as a result of inconsistent epidemiologic evidence. An International Agency for Research on Cancer (IARC) working group evaluated benzene in 2009 and noted evidence for a positive association between benzene exposure and NHL risk. OBJECTIVE We evaluated the association between occupational benzene exposure and NHL among 73,087 women enrolled in the prospective population-based Shanghai Women's Health Study. METHODS Benzene exposure estimates were derived using a previously developed exposure assessment framework that combined ordinal job-exposure matrix intensity ratings with quantitative benzene exposure measurements from an inspection database of Shanghai factories collected between 1954 and 2000. Associations between benzene exposure metrics and NHL (n = 102 cases) were assessed using Cox proportional hazard models, with study follow-up occurring from December 1996 through December 2009. RESULTS Women ever exposed to benzene had a significantly higher risk of NHL [hazard ratio (HR) = 1.87, 95% CI: 1.19, 2.96]. Compared with unexposed women, significant trends in NHL risk were observed for increasing years of benzene exposure (p(trend) = 0.006) and increasing cumulative exposure levels (p(trend) = 0.005), with the highest duration and cumulative exposure tertiles having a significantly higher association with NHL (HR = 2.07, 95% CI: 1.07, 4.01 and HR = 2.16, 95% CI: 1.17, 3.98, respectively). CONCLUSIONS Our findings, using a population-based prospective cohort of women with diverse occupational histories, provide additional evidence that occupational exposure to benzene is associated with NHL risk.
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Affiliation(s)
- Bryan A Bassig
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
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26
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Linet MS, Yin SN, Gilbert ES, Dores GM, Hayes RB, Vermeulen R, Tian HY, Lan Q, Portengen L, Ji BT, Li GL, Rothman N. A retrospective cohort study of cause-specific mortality and incidence of hematopoietic malignancies in Chinese benzene-exposed workers. Int J Cancer 2015; 137:2184-97. [PMID: 25944549 DOI: 10.1002/ijc.29591] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 02/19/2015] [Accepted: 02/23/2015] [Indexed: 12/31/2022]
Abstract
Benzene exposure has been causally linked with acute myeloid leukemia (AML), but inconsistently associated with other hematopoietic, lymphoproliferative and related disorders (HLD) or solid tumors in humans. Many neoplasms have been described in experimental animals exposed to benzene. We used Poisson regression to estimate adjusted relative risks (RR) and the likelihood ratio statistic to derive confidence intervals for cause-specific mortality and HLD incidence in 73,789 benzene-exposed compared with 34,504 unexposed workers in a retrospective cohort study in 12 cities in China. Follow-up and outcome assessment was based on factory, medical and other records. Benzene-exposed workers experienced increased risks for all-cause mortality (RR = 1.1, 95% CI = 1.1, 1.2) due to excesses of all neoplasms (RR = 1.3, 95% CI = 1.2, 1.4), respiratory diseases (RR = 1.7, 95% CI = 1.2, 2.3) and diseases of blood forming organs (RR = ∞, 95% CI = 3.4, ∞). Lung cancer mortality was significantly elevated (RR = 1.5, 95% CI = 1.2, 1.9) with similar RRs for males and females, based on three-fold more cases than in our previous follow-up. Significantly elevated incidence of all myeloid disorders reflected excesses of myelodysplastic syndrome/acute myeloid leukemia (RR = 2.7, 95% CI = 1.2, 6.6) and chronic myeloid leukemia (RR = 2.5, 95% CI = 0.8, 11), and increases of all lymphoid disorders included excesses of non-Hodgkin lymphoma (RR = 3.9, 95%CI = 1.5, 13) and all lymphoid leukemia (RR = 5.4, 95%CI = 1.0, 99). The 28-year follow-up of Chinese benzene-exposed workers demonstrated increased risks of a broad range of myeloid and lymphoid neoplasms, lung cancer, and respiratory diseases and suggested possible associations with other malignant and non-malignant disorders.
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Affiliation(s)
- Martha S Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD
| | - Song-Nian Yin
- National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ethel S Gilbert
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD
| | - Graça M Dores
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD
| | - Richard B Hayes
- Division of Epidemiology, Department of Population Health, New York University School of Medicine, New York, NY
| | - Roel Vermeulen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Hao-Yuan Tian
- National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qing Lan
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD
| | - Lutzen Portengen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Bu-Tian Ji
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD
| | - Gui-Lan Li
- National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Nathaniel Rothman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD
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27
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Edokpolo B, Yu QJ, Connell D. Health risk characterization for exposure to benzene in service stations and petroleum refineries environments using human adverse response data. Toxicol Rep 2015; 2:917-927. [PMID: 28962430 PMCID: PMC5598410 DOI: 10.1016/j.toxrep.2015.06.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 05/25/2015] [Accepted: 06/02/2015] [Indexed: 01/13/2023] Open
Abstract
Health risk characterization of exposure to benzene in service stations and petroleum refineries has been carried out in previous studies using guideline values set by various agencies. In this work, health risk was characterized with the exposure data as cumulative probability distribution (CPD) plots but using human epidemiological data. This was achieved by using lowest observable adverse effects levels (LOAEL) data plotted as cumulative probability lowest effects distribution (CPLED). The health risk due to benzene was characterized by using probabilistic methods of hazard quotient (HQ50/50 and HQ95/5), Monte-Carlo simulation (MCS) and overall risk probability (ORP). CPD relationships of adverse health effects relationships and exposure data were in terms of average daily dose (ADD) and lifetime average daily dose (LADD) for benzene. For service station environments HQ50/50 and HQ95/5 were in a range of 0.000071-0.055 and 0.0049-21, respectively. On the other hand, the risk estimated for petroleum refinery environments suggests higher risk with HQ50/50 and HQ95/5 values ranging from 0.0012 to 77 and 0.17 to 560, respectively. The results of Monte-Carlo risk probability (MRP) and ORP indicated that workers in petroleum refineries (MRP of 2.9-56% and ORP of 4.6-52% of the affected population) were at a higher risk of adverse health effects from exposure to benzene as compared to exposure to benzene in service station environments (MRP of 0.051 -3.4% and ORP of 0.35-2.7% affected population). The adverse effect risk probabilities estimated by using the Monte-Carlo simulation technique and the ORP method were found to be generally consistent.
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Affiliation(s)
- Benjamin Edokpolo
- Griffith School of Engineering, Griffith University, Nathan Campus, Brisbane 4111, QLD, Australia
| | - Qiming Jimmy Yu
- Griffith School of Engineering, Griffith University, Nathan Campus, Brisbane 4111, QLD, Australia
| | - Des Connell
- Griffith School of Environment, Griffith University, Nathan Campus, Brisbane 4111, QLD, Australia
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Stenehjem JS, Kjærheim K, Bråtveit M, Samuelsen SO, Barone-Adesi F, Rothman N, Lan Q, Grimsrud TK. Benzene exposure and risk of lymphohaematopoietic cancers in 25 000 offshore oil industry workers. Br J Cancer 2015; 112:1603-12. [PMID: 25867262 PMCID: PMC4453669 DOI: 10.1038/bjc.2015.108] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Revised: 02/20/2015] [Accepted: 02/24/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The aim of this work was to examine the risk of lymphohaematopoietic (LH) cancer according to benzene exposure among offshore workers. METHODS Cancer registry data were used to identify 112 cancer cases diagnosed during 1999-2011 in a cohort of 24 917 Norwegian men reporting offshore work between 1965 and 1999. Analyses were conducted according to a stratified case-cohort design with a reference subcohort of 1661 workers. Cox regression was used to estimate hazard ratios with 95% confidence intervals, adjusted for other benzene exposure and smoking. RESULTS Most workers were exposed to benzene for <15 years. The upper range values of average intensity and cumulative exposure were estimated to 0.040 p.p.m. and 0.948 p.p.m.-years, respectively. Risks were consistently elevated among exposed workers for all LH cancers combined and for most subgroups, although case numbers were small and yielded imprecise risk estimates. There was evidence of dose-related risk patterns according to cumulative exposure for acute myeloid leukaemia (AML), multiple myeloma (MM) (P trends 0.052 and 0.024, respectively), and suggestively so for chronic lymphocytic leukaemia (CLL) according to average intensity (P trend 0.094). CONCLUSIONS Our results support an association between cumulative and intensity metrics of low-level benzene exposure and risk for AML, MM, and suggestively for CLL.
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Affiliation(s)
- J S Stenehjem
- Department of Research, Cancer Registry of Norway, P.O. Box 5313 Majorstuen, Oslo N-0304, Norway
| | - K Kjærheim
- Department of Research, Cancer Registry of Norway, P.O. Box 5313 Majorstuen, Oslo N-0304, Norway
| | - M Bråtveit
- Department of Global Public Health and Primary Care, University of Bergen, Bergen N-5020, Norway
| | - S O Samuelsen
- Department of Mathematics, University of Oslo, Oslo N-0316, Norway
| | - F Barone-Adesi
- Population Health Research Institute, St George's University of London, London SW17 0RE, UK
- Department of Pharmaceutical Sciences, University of Eastern Piedmont, Novara 28100, Italy
| | - N Rothman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA
| | - Q Lan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA
| | - T K Grimsrud
- Department of Research, Cancer Registry of Norway, P.O. Box 5313 Majorstuen, Oslo N-0304, Norway
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Hamidin N, Yu J, Phung DT, Connell D, Chu C. Volatile aromatic hydrocarbons (VAHs) in residential indoor air in Brisbane, Australia. CHEMOSPHERE 2013; 92:1430-1435. [PMID: 23683354 DOI: 10.1016/j.chemosphere.2013.03.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 03/19/2013] [Accepted: 03/29/2013] [Indexed: 06/02/2023]
Abstract
Volatile aromatic hydrocarbons (VAHs: benzene, toluene, ethylbenzene, mp-xylene, o-xylene, styrene, naphthalene) in residential indoor air in Brisbane, Australia were measured in 32 houses. The total VAHs (TVAHs) levels ranged between 2 and 137μg/m(3) and were lower than the most of the houses in the literature data. The VAHs were believed to originate from heat insulation systems, building material products as well motor vehicles but naphthalene and styrene originated from other sources. Internal garages had concentrations which are higher than the indoor air by 25-50% due to the presence of motor vehicles and may be a major source of indoor VAHs. However indoor concentrations are higher than that in the outdoor ambient air. The age of the house was found to be negatively related to VAHs concentrations in the houses with the half-life of TVAH at approximately 13years. The concentration levels of benzene, toluene, ethylbenzene and styrene are well below the guideline values set by agencies from Hong Kong, Japan, Germany and the WHO while the concentration level of naphthalene in one house exceeded the guideline value from Germany.
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Affiliation(s)
- Nasrul Hamidin
- Griffith School of Environment, Griffith University, 170 Kessels Road, Nathan, QLD 4111, Australia
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30
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Sielken RL, Valdez-Flores C. Quantitative risk assessment of exposures to butadiene in EU occupational settings based on the University of Alabama at Birmingham epidemiological study. Regul Toxicol Pharmacol 2013; 65:214-25. [DOI: 10.1016/j.yrtph.2012.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 12/06/2012] [Accepted: 12/12/2012] [Indexed: 10/27/2022]
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31
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Brown T, Rushton L. Occupational cancer in Britain. Haematopoietic malignancies: leukaemia, multiple myeloma, non-Hodgkins lymphoma. Br J Cancer 2012; 107 Suppl 1:S41-8. [PMID: 22710678 PMCID: PMC3384012 DOI: 10.1038/bjc.2012.117] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Terry Brown
- Institute of Environment and Health, Cranfield Health, Cranfield University, Cranfield MK43 0AL, UK
| | - Lesley Rushton
- Department of Epidemiology and Biostatistics, School of Public Health and MRC-HPA Centre for Environment and Health, Imperial College London, St Mary's Campus, Norfolk Place, London W2 3PG, UK
| | - with the British Occupational Cancer Burden Study Group
- Institute of Environment and Health, Cranfield Health, Cranfield University, Cranfield MK43 0AL, UK
- Department of Epidemiology and Biostatistics, School of Public Health and MRC-HPA Centre for Environment and Health, Imperial College London, St Mary's Campus, Norfolk Place, London W2 3PG, UK
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32
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Peng D, Jiaxing W, Chunhui H, Weiyi P, Xiaomin W. Study on the cytogenetic changes induced by benzene and hydroquinone in human lymphocytes. Hum Exp Toxicol 2012; 31:322-35. [DOI: 10.1177/0960327111433900] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Benzene (BN) is a prototypical hematotoxicant, genotoxic carcinogen, and ubiquitous environmental pollutant. Although the molecular mechanisms of BN-induced cytotoxicity and genotoxic damage are poorly understood in humans, previous studies suggested that bioactivated BN metabolites are capable of oxidative stress, cell cycle arrest, apoptosis, and DNA damage. The objective of the current study was to investigate the BN-induced cytogenetic changes and underlying mechanisms based on these hypotheses. Peripheral blood lymphocytes (PBLs) might be the targets for BN-induced cytotoxicity and genotoxicity, and therefore DNA damage responses of PBLs after exposure to different concentrations of BN (0.25, 3.5, 50 μmol/L) or BN metabolite, hydroquinone (HQ; 50, 150, 450 μmol/L) were studied in vitro. Microculture tetrazolium assay, flow cytometry, 2′,7′-dichlorodihydrofluorescein-diacetate assay, comet assay, micronuclei assay, and attenuated total reflectance microspectroscope were chosen for this study. Based on the results, we reached the conclusion that different concentrations of BN or HQ significantly inhibited cell growth, induced the arrest of S phase and G2/M phase, and increased late apoptosis in a concentration-dependent manner. Furthermore, evidence was also provided to support the conclusion that BN and HQ induced DNA strand breaks and chromosomal mutations in PBL, which indicated the genotoxicity of BN and HQ. Current evidence has indicated that multiple mechanisms including dysfunction of cell cycle, programmed cell death, oxidative stress, and DNA lesions are likely to contribute to BN-induced cytogenetic changes.
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Affiliation(s)
- D Peng
- Department of Public Health, School of Basic Medical, Hubei University of Medicine, Shiyan, Hubei, PR China
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, Guangxi, PR China
| | - W Jiaxing
- School of Chemical Project, Beijing University of Chemical Technology, Beijing, PR China
| | - H Chunhui
- Department of Clinical Laboratories, the Affiliated Taihe Hospital, Hubei University of Medicine, Hubei Shiyan, PR China
| | - P Weiyi
- Department of Health Statistics and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi, PR China
| | - W Xiaomin
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, Guangxi, PR China
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The role of residence near hazardous waste sites containing benzene in the development of hematologic cancers in upstate New York. Int J Occup Med Environ Health 2011; 24:327-38. [PMID: 22002323 DOI: 10.2478/s13382-011-0037-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Accepted: 08/04/2011] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Epidemiologic studies suggest an association between environmental exposure to benzene and hematologic cancers, but the relationship is not firmly established. The aim of this study was to assess the potential association between residence near hazardous waste sites containing benzene and hospitalization discharge rates for persons having hematologic cancers. MATERIALS AND METHODS We determined the number of hospital discharges of people with hematologic cancers in New York State except for New York City for the years 1993 to 2008.Descriptive statistics and negative binomial regression models were used to compare the rates of hospitalization of residents in zip codes containing hazardous waste sites containing benzene to the rates of discharges from residents in zip codes without waste sites. RESULTS When adjusting for potential confounders we found a 15% increase in the rate of hospitalization for chronic lymphatic leukemia (CLL) [rate ratio (RR): 1.15; 95% confidence interval (CI): 1.00-1.33], a 22% increase in the rate of discharges for total leukemia (RR: 1.22; 95% CI: 1.04-1.43) and a 17% increase in the rate of discharges for total lymphoma (RR: 1.17; 95% CI: 1.02-1.35) in the benzene exposed sites. We found greater effects of exposure in African Americans compared to Caucasians, females compared to males and people with higher socioeconomic status (SES) compared to those with lower SES for several of the diseases studied. CONCLUSIONS After controlling for major confounders we found statistically significant increases in discharge rates for several hematologic cancers in persons residing in zip codes containing benzene waste sites. These results provide additional support for a relationship between environmental exposure to benzene and risk of hematologic cancers.
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Pyatt DW, Hays SM, English C, Cushing CA. United States Voluntary Children's Chemical Evaluation Program (VCCEP) risk assessment for children exposed to benzene. Toxicol Mech Methods 2011; 22:81-104. [PMID: 21859365 DOI: 10.3109/15376516.2011.596232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
As part of the Voluntary Children's Chemical Evaluation Program (VCCEP) program, a risk assessment was performed to evaluate the risks to children from environmental benzene exposures. This paper summarizes this risk assessment. Risk was characterized using two distinct methods: USEPA's default type of risk assessment, which used the Reference Dose (RfD) and Cancer Slope Factor (CSF) to characterize non-cancer and cancer risks, as well as a Margin of Safety (MOS) approach that utilized a point of departure (POD). The exposures for most scenarios evaluated in this VCCEP risk assessment are lower than both the cancer and non-cancer PODs by several orders of magnitude, indicating a large MOS and corresponding low potential for toxicity at these exposures. The highest benzene exposures likely experienced by children, associated with the lowest MOS, are from cigarette smoke. In addition, the potential for age-related differences in the sensitivity towards benzene-induced toxicity was investigated. In general, this risk assessment does not indicate that children are likely to be at a elevated risk of AML or hematopoietic toxicity associated with environmental exposures to benzene.
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Affiliation(s)
- David W Pyatt
- Summit Toxicology, L.L.P., University of Colorado, School of Pharmacy, Denver, CO, USA.
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Kim EA, Lee HE, Ryu HW, Park SH, Kang SK. Cases series of malignant lymphohematopoietic disorder in korean semiconductor industry. Saf Health Work 2011; 2:122-34. [PMID: 22953195 PMCID: PMC3431896 DOI: 10.5491/shaw.2011.2.2.122] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Accepted: 04/14/2011] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Seven cases of malignant lymphohematopoietic (LHP) disorder were claimed to have developed from occupational exposure at two plants of a semiconductor company from 2007 to 2010. This study evaluated the possibility of exposure to carcinogenic agents for the cases. METHODS Clinical courses were reviewed with assessing possible exposure to carcinogenic agents related to LHP cancers. Chemicals used at six major semiconductor companies in Korea were reviewed. Airborne monitoring for chemicals, including benzene, was conducted and the ionizing radiation dose was measured from 2008 to 2010. RESULTS The latency of seven cases (five leukemiae, a Non-Hodgkin's lymphoma, and an aplastic anemia) ranged from 16 months to 15 years and 5 months. Most chemical measurements were at levels of less than 10% of the Korean Occupational Exposure Limit value. No carcinogens related to LHP cancers were used or detected. Complete-shielded radiation-generating devices were used, but the ionizing radiation doses were 0.20-0.22 uSv/hr (background level: 0.21 µSv/hr). Airborne benzene was detected at 0.31 ppb when the detection limit was lowered as low as possible. Ethylene oxide and formaldehyde were not found in the cases' processes, while these two were determined to be among the 263 chemicals in the list that was used at the six semiconductor companies at levels lower than 0.1%. Exposures occurring before 2002 could not be assessed because of the lack of information. CONCLUSION Considering the possibility of exposure to carcinogenic agents, we could not find any convincing evidence for occupational exposure in all investigated cases. However, further study is needed because the semiconductor industry is a newly developing one.
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Affiliation(s)
- Eun-A Kim
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Incheon, Korea
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Felter SP, Conolly RB, Bercu JP, Bolger PM, Boobis AR, Bos PMJ, Carthew P, Doerrer NG, Goodman JI, Harrouk WA, Kirkland DJ, Lau SS, Llewellyn GC, Preston RJ, Schoeny R, Schnatter AR, Tritscher A, van Velsen F, Williams GM. A proposed framework for assessing risk from less-than-lifetime exposures to carcinogens. Crit Rev Toxicol 2011; 41:507-44. [DOI: 10.3109/10408444.2011.552063] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Talbott EO, Xu X, Youk AO, Rager JR, Stragand JA, Malek AM. Risk of leukemia as a result of community exposure to gasoline vapors: a follow-up study. ENVIRONMENTAL RESEARCH 2011; 111:597-602. [PMID: 21453914 DOI: 10.1016/j.envres.2011.03.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2010] [Revised: 03/09/2011] [Accepted: 03/15/2011] [Indexed: 05/30/2023]
Abstract
OBJECTIVES To assess the temporal and spatial relationship of risk for total leukemia and AML (acute myelogenous leukemia) among community residents of an area in northeastern (NE) Pennsylvania (PA) affected by the Tranguch Gasoline Spill which occurred in the early 1990s. METHODS Standardized incidence ratios (SIR) were calculated for total leukemia and AML among 625 residents affected by the gasoline spill in relation to both PA and local county cancer incidence rates. The risk of total leukemia and AML among the gasoline exposed population was evaluated for the period prior to the spill, 1985-1989; during the time surrounding the spill, 1990-1994; and for a period subsequent to the spill, 1995-2001. RESULTS The incidence of total leukemia and AML was significantly elevated subsequent to the spill for the entire period 1990-2001 and was highest for the period 1995-2001, whether comparison was made to PA or local county leukemia rates. Based on comparison to PA rates, the SIRs for total leukemia and AML were 7.69 (95% CI=1.58-22.46) and 11.54 (95% CI=2.38-33.69) for the 1995-2001 period, respectively. Prior to the spill, 1985-1989, and during the period of the spill, 1990-1994, no cases of leukemia were identified among the affected residents. CONCLUSIONS These results suggest a possible association between chronic low level benzene exposure and increased risk of leukemia among residents of the Tranguch Spill Site in NE PA. Our study provides additional support to the growing body of evidence implicating low level benzene exposure and cancer risk. We recommend that other communities contaminated with gasoline vapor through leaking underground storage vessels be monitored for elevated risk of leukemia.
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Affiliation(s)
- Evelyn O Talbott
- University of Pittsburgh, Graduate School of Public Health, Departments of Epidemiology, Pittsburgh, PA 15261, USA.
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Lymphohematopoietic cancer mortality and morbidity of workers in a refinery/petrochemical complex in Korea. Saf Health Work 2011; 2:26-33. [PMID: 22953184 PMCID: PMC3431886 DOI: 10.5491/shaw.2011.2.1.26] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Accepted: 10/16/2010] [Indexed: 11/23/2022] Open
Abstract
Objectives The purpose of this retrospective cohort study was to investigate the relationship between exposure of Korean workers to petrochemicals in the refinery/petrochemical industry and lymphohematopoietic cancers. Methods The cohort consisted of 8,866 male workers who had worked from the 1960s to 2007 at one refinery and six petrochemical companies located in a refinery/petrochemical complex in Korea that produce benzene or use benzene as a raw material. Standardized mortality ratios (SMRs) and standardized incidence ratios (SIRs) were calculated for 1992-2007 and 1997-2005 based on the death rate and cancer incidence rate of the Korean male population according to job title (production, maintenance, laboratory, and office workers). Results The overall mortality and most cause-specific mortalities were lower among these workers than those of the general Korean population. Increased SMRs were observed for leukemia (4/1.45; SMR 2.77, 95% CI: 0.75-7.09) and lymphohematopoietic cancers (5/2.51; SMR 2, 95% CI: 0.65-4.66) in production workers, and increased SIRs were also observed in leukemia (3/1.34; SIR 2.24, 95% CI: 0.46-6.54) and lymphohematopoietic cancers (5/3.39; SIR 1.47, 95% CI: 0.48-3.44) in production workers, but the results were not statistically significant. Conclusion The results showed a potential relationship between leukemia and lymphohematopoietic cancers and exposure to benzene in refinery/petrochemical complex workers. This study yielded limited results due to a short observational period; therefore, a follow-up study must be performed to elucidate the relationship between petrochemical exposure and cancer rates.
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Occupational exposure levels to benzene in Italy: findings from a national database. Int Arch Occup Environ Health 2011; 84:617-25. [DOI: 10.1007/s00420-011-0616-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Accepted: 01/12/2011] [Indexed: 01/18/2023]
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Vlaanderen J, Lan Q, Kromhout H, Rothman N, Vermeulen R. Occupational benzene exposure and the risk of lymphoma subtypes: a meta-analysis of cohort studies incorporating three study quality dimensions. ENVIRONMENTAL HEALTH PERSPECTIVES 2011; 119:159-67. [PMID: 20880796 PMCID: PMC3040601 DOI: 10.1289/ehp.1002318] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Accepted: 09/29/2010] [Indexed: 05/22/2023]
Abstract
BACKGROUND The use of occupational cohort studies to assess the association of benzene and lymphoma is complicated by problems with exposure misclassification, outcome classification, and low statistical power. OBJECTIVE We performed meta-analyses of occupational cohort studies for five different lymphoma categories: Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL), multiple myeloma (MM), acute lymphocytic leukemia (ALL), and chronic lymphocytic leukemia (CLL). DATA EXTRACTION We assessed three study quality dimensions to evaluate the impact of study quality variations on meta-relative risks (mRRs): stratification by the year of start of follow-up, stratification by the strength of the reported acute myelogenous leukemia association, and stratification by the quality of benzene exposure assessment. DATA SYNTHESIS mRRs for MM, ALL, and CLL increased with increasing study quality, regardless of the study quality dimension. mRRs for NHL also increased with increasing study quality, although this effect was less pronounced. We observed no association between occupational benzene exposure and HL. CONCLUSIONS Our meta-analysis provides support for an association between occupational benzene exposure and risk of MM, ALL, and CLL. The evidence for an association with NHL is less clear, but this is likely complicated by the etiologic heterogeneity of this group of diseases. Further consideration of the association between benzene and NHL will require delineation of risks by NHL subtype.
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Affiliation(s)
- Jelle Vlaanderen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Qing Lan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Department of Health and Human Services, National Institutes of Health, Bethesda, Maryland, USA
| | - Hans Kromhout
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Nathaniel Rothman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Department of Health and Human Services, National Institutes of Health, Bethesda, Maryland, USA
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
- Address correspondence to R. Vermeulen, Institute for Risk Assessment Sciences, Division Environmental Epidemiology, Jenalaan 18d, 3584 CK, Utrecht, the Netherlands. Telephone: 31-30-2539448. Fax: 31-30-2539499. E-mail:
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Galbraith D, Gross SA, Paustenbach D. Benzene and human health: A historical review and appraisal of associations with various diseases. Crit Rev Toxicol 2010; 40 Suppl 2:1-46. [DOI: 10.3109/10408444.2010.508162] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Khalade A, Jaakkola MS, Pukkala E, Jaakkola JJK. Exposure to benzene at work and the risk of leukemia: a systematic review and meta-analysis. Environ Health 2010; 9:31. [PMID: 20584305 PMCID: PMC2903550 DOI: 10.1186/1476-069x-9-31] [Citation(s) in RCA: 145] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2009] [Accepted: 06/28/2010] [Indexed: 05/19/2023]
Abstract
BACKGROUND A substantial number of epidemiologic studies have provided estimates of the relation between exposure to benzene at work and the risk of leukemia, but the results have been heterogeneous. To bridge this gap in knowledge, we synthesized the existing epidemiologic evidence on the relation between occupational exposure to benzene and the risk of leukemia, including all types combined and the four main subgroups acute myeloid leukemia (AML), acute lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL), and chronic myeloid leukemia (CML). METHODS A systematic literature review was carried out using two databases 'Medline' and 'Embase' from 1950 through to July 2009. We selected articles which provided information that can be used to estimate the relation between benzene exposure and cancer risk (effect size). RESULTS In total 15 studies were identified in the search, providing 16 effect estimates for the main analysis. The summary effect size for any leukemia from the fixed-effects model was 1.40 (95% CI, 1.23-1.57), but the study-specific estimates were strongly heterogeneous (I2 = 56.5%, Q stat = 34.47, p = 0.003). The random-effects model yielded a summary- effect size estimate of 1.72 (95% CI, 1.37-2.17). Effect estimates from 9 studies were based on cumulative exposures. In these studies the risk of leukemia increased with a dose-response pattern with a summary-effect estimate of 1.64 (95% CI, 1.13-2.39) for low (< 40 ppm-years), 1.90 (95% CI, 1.26-2.89) for medium (40-99.9 ppm-years), and 2.62 (95% CI, 1.57-4.39) for high exposure category (> 100 ppm-years). In a meta-regression, the trend was statistically significant (P = 0.015). Use of cumulative exposure eliminated heterogeneity. The risk of AML also increased from low (1.94, 95% CI, 0.95-3.95), medium (2.32, 95% CI, 0.91-5.94) to high exposure category (3.20, 95% CI, 1.09-9.45), but the trend was not statistically significant. CONCLUSIONS Our study provides consistent evidence that exposure to benzene at work increases the risk of leukemia with a dose-response pattern. There was some evidence of an increased risk of AML and CLL. The meta-analysis indicated a lack of association between benzene exposure and the risk of CML.
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Affiliation(s)
- Abdul Khalade
- Institute of Occupational and Environmental Medicine, University of Birmingham, UK
| | - Maritta S Jaakkola
- Center for Environmental and Respiratory Health Research, Respiratory Medicine Unit, Department of Internal Medicine, Institute of Clinical Medicine, University of Oulu, P.O. B. 5000, 90014 Oulu, Finland
| | - Eero Pukkala
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Pieni Roobertinkatu 9, Helsinki, Finland
- School of Public Health, University of Tampere, Tampere, Finland
| | - Jouni JK Jaakkola
- Institute of Occupational and Environmental Medicine, University of Birmingham, UK
- Center for Environmental and Respiratory Health Research, Institute of Health Sciences, University of Oulu, P.O. B. 5000, 90014 Oulu, Finland
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Weed DL. Meta-Analysis and Causal Inference: A Case Study of Benzene and Non-Hodgkin Lymphoma. Ann Epidemiol 2010; 20:347-55. [DOI: 10.1016/j.annepidem.2010.02.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2009] [Revised: 02/01/2010] [Accepted: 02/05/2010] [Indexed: 12/20/2022]
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Vlaanderen J, Portengen L, Rothman N, Lan Q, Kromhout H, Vermeulen R. Flexible meta-regression to assess the shape of the benzene-leukemia exposure-response curve. ENVIRONMENTAL HEALTH PERSPECTIVES 2010; 118:526-32. [PMID: 20064779 PMCID: PMC2854730 DOI: 10.1289/ehp.0901127] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2009] [Accepted: 11/18/2009] [Indexed: 05/19/2023]
Abstract
BACKGROUND Previous evaluations of the shape of the benzene-leukemia exposure-response curve (ERC) were based on a single set or on small sets of human occupational studies. Integrating evidence from all available studies that are of sufficient quality combined with flexible meta-regression models is likely to provide better insight into the functional relation between benzene exposure and risk of leukemia. OBJECTIVES We used natural splines in a flexible meta-regression method to assess the shape of the benzene-leukemia ERC. METHODS We fitted meta-regression models to 30 aggregated risk estimates extracted from nine human observational studies and performed sensitivity analyses to assess the impact of a priori assessed study characteristics on the predicted ERC. RESULTS The natural spline showed a supralinear shape at cumulative exposures less than 100 ppm-years, although this model fitted the data only marginally better than a linear model (p = 0.06). Stratification based on study design and jackknifing indicated that the cohort studies had a considerable impact on the shape of the ERC at high exposure levels (> 100 ppm-years) but that predicted risks for the low exposure range (< 50 ppm-years) were robust. CONCLUSIONS Although limited by the small number of studies and the large heterogeneity between studies, the inclusion of all studies of sufficient quality combined with a flexible meta-regression method provides the most comprehensive evaluation of the benzene-leukemia ERC to date. The natural spline based on all data indicates a significantly increased risk of leukemia [relative risk (RR) = 1.14; 95% confidence interval (CI), 1.04-1.26] at an exposure level as low as 10 ppm-years.
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Affiliation(s)
- Jelle Vlaanderen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
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Benzene Exposure and Non-Hodgkin Lymphoma: A Meta-Analysis of Epidemiologic Studies. J Occup Environ Med 2010; 52:169-89. [DOI: 10.1097/jom.0b013e3181cc9cf0] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kane EV, Newton R. Benzene and the risk of non-Hodgkin lymphoma: A review and meta-analysis of the literature. Cancer Epidemiol 2010; 34:7-12. [DOI: 10.1016/j.canep.2009.12.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2009] [Revised: 12/10/2009] [Accepted: 12/10/2009] [Indexed: 10/20/2022]
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Johnson GT, Harbison SC, McCluskey JD, Harbison RD. Characterization of cancer risk from airborne benzene exposure. Regul Toxicol Pharmacol 2009; 55:361-6. [DOI: 10.1016/j.yrtph.2009.08.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2009] [Revised: 07/30/2009] [Accepted: 08/18/2009] [Indexed: 11/29/2022]
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Rushton L, Brown TP, Cherrie J, Fortunato L, Van Tongeren M, Hutchings SJ. How much does benzene contribute to the overall burden of cancer due to occupation? Chem Biol Interact 2009; 184:290-2. [PMID: 19914225 DOI: 10.1016/j.cbi.2009.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- L Rushton
- Imperial College London, Department of Public Health and Epidemiology, Faculty of Medicine, Norfolk Place, London W2 3PG, UK.
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Associations of common variants in genes involved in metabolism and response to exogenous chemicals with risk of multiple myeloma. Cancer Epidemiol 2009; 33:276-80. [PMID: 19736056 DOI: 10.1016/j.canep.2009.08.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2009] [Accepted: 08/14/2009] [Indexed: 11/20/2022]
Abstract
BACKGROUND We examined risk of multiple myeloma (MM) associated with variants in genes involved in metabolism and response to exogenous chemicals [cytochrome P450 enzymes (CYP1B1, CYP2C9), epoxide hydrolase (EPHX1), paraoxonase 1 (PON1), arylhydrocarbon hydroxylase receptor (AHR), and NAD(P)H:quinone oxidoreductase (NQO1)]. METHODS This study included 279 MM cases and 782 controls in a pooled analysis of two population-based case-control studies. One common variant from each candidate gene was genotyped using DNA from blood or buccal cells. We estimated risk of MM associated with each genotype, controlling for race, gender, study site, and age, using odds ratios (OR) and 95% confidence intervals (CI). RESULTS Evaluations of the CYP1B1 V432L variant (rs1056836) suggested increased risk of MM among persons with the CG and GG genotypes compared to the CC genotype [OR (95% CI)=1.4 (1.0-2.0)]. Similar results were seen in analyses stratified by race and gender. We did not find any associations between MM and the CYP2C9, EPHX1, NQO1, or PON1 genes. CONCLUSIONS CYP1B1 activates chemicals such as polycyclic aromatic hydrocarbons and dioxins to create oxidized, reactive intermediates, and higher gene activity has been shown for the G allele. We conducted the largest analysis to date on MM and these genetic variants and our results provide preliminary evidence that variation in CYP1B1 may influence susceptibility to MM.
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Wilbur S, Wohlers D, Paikoff S, Keith LS, Faroon O. ATSDR evaluation of health effects of benzene and relevance to public health. Toxicol Ind Health 2009; 24:263-398. [PMID: 19022880 DOI: 10.1177/0748233708090910] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
As part of its mandate, the Agency for Toxic Substances and Disease Registry (ATSDR) prepares toxicological profiles on hazardous chemicals found at Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) National Priorities List (NPL) sites that have the greatest public health impact. These profiles comprehensively summarize toxicological and environmental information. This article constitutes the release of portions of the Toxicological Profile for Benzene. The primary purpose of this article is to provide public health officials, physicians, toxicologists, and other interested individuals and groups with an overall perspective on the toxicology of benzene. It contains descriptions and evaluations of toxicological studies and epidemiological investigations and provides conclusions, where possible, on the relevance of toxicity and toxicokinetic data to public health.
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Affiliation(s)
- S Wilbur
- Agency for Toxic Substances and Disease Registry (ATSDR), U.S. Department of Health and Human Services, Atlanta, Georgia 30333, USA.
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