Skip to main content
Occupational and Environmental Medicine logoLink to Occupational and Environmental Medicine
. 1995 Jun;52(6):380–384. doi: 10.1136/oem.52.6.380

Risk of acute myeloid leukaemia and multiple myeloma in workers exposed to benzene.

O Wong 1
PMCID: PMC1128241  PMID: 7627314

Abstract

OBJECTIVE--To determine the risk of developing acute myeloid leukaemia (AML) and multiple myeloma in a cohort of workers exposed to benzene. The results were used to show the importance of taking specificity of disease into consideration in causation analysis. METHODS--Data were derived from a cohort of workers employed at two Goodyear plants in Ohio in the manufacture of Pliofilm. Based on data in the Pliofilm study, several papers that examined the relation between exposure to benzene and leukaemia (all cell types combined) have been published. In the current analyses based on updated data in the study, standardised mortality ratios (SMRs) and 95% confidence intervals (95% CIs) were calculated for AML and multiple myeloma by cumulative exposure to benzene. The results based on AML were compared with those for leukaemia (all cell types combined) published previously. RESULTS--An exposure response relation was shown between cumulative exposure to benzene and AML. No increased risk of AML was detected for cumulative exposure to benzene below 200 ppm-years (SMR 0.91). Above 200 ppm-years, risk of AML rose drastically; reaching a significant SMR of 98.37 for > 400 ppm-years. For multiple myeloma, no relation with exposure to benzene was detected. CONCLUSION--Analysis specific to AML shows the importance of taking specificity of disease into consideration in causation analysis. This investigation shows that previous analyses based on all leukaemia cell types combined have incorrectly set the estimated threshold too low, and have underestimated risk above the threshold. Current regulatory policies that rely on previous analyses based on all leukaemia cell types combined should be re-examined.

Full text

PDF
380

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aksoy M., Erdem S., Dinçol G., Kutlar A., Bakioğlu I., Hepyüksel T. Clinical observations showing the role of some factors in the etiology of multiple myeloma. A study in 7 patients. Acta Haematol. 1984;71(2):116–120. doi: 10.1159/000206568. [DOI] [PubMed] [Google Scholar]
  2. Brandt L., Nilsson P. G., Mitelman F. Occupational exposure to petroleum products in men with acute non-lymphocytic leukaemia. Br Med J. 1978 Mar 4;1(6112):553–553. doi: 10.1136/bmj.1.6112.553. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Cuzick J., De Stavola B. Multiple myeloma--a case-control study. Br J Cancer. 1988 May;57(5):516–520. doi: 10.1038/bjc.1988.118. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Eriksson M., Karlsson M. Occupational and other environmental factors and multiple myeloma: a population based case-control study. Br J Ind Med. 1992 Feb;49(2):95–103. doi: 10.1136/oem.49.2.95. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Flodin U., Fredriksson M., Persson B. Multiple myeloma and engine exhausts, fresh wood, and creosote: a case-referent study. Am J Ind Med. 1987;12(5):519–529. doi: 10.1002/ajim.4700120506. [DOI] [PubMed] [Google Scholar]
  6. Ford A. M., Molgaard H. V., Greaves M. F., Gould H. J. Immunoglobulin gene organisation and expression in haemopoietic stem cell leukaemia. EMBO J. 1983;2(6):997–1001. doi: 10.1002/j.1460-2075.1983.tb01533.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. HILL A. B. THE ENVIRONMENT AND DISEASE: ASSOCIATION OR CAUSATION? Proc R Soc Med. 1965 May;58:295–300. [PMC free article] [PubMed] [Google Scholar]
  8. Infante P. F., Rinsky R. A., Wagoner J. K., Young R. J. Leukaemia in benzene workers. Lancet. 1977 Jul 9;2(8028):76–78. doi: 10.1016/s0140-6736(77)90074-5. [DOI] [PubMed] [Google Scholar]
  9. Irons R. D., Stillman W. S., Colagiovanni D. B., Henry V. A. Synergistic action of the benzene metabolite hydroquinone on myelopoietic stimulating activity of granulocyte/macrophage colony-stimulating factor in vitro. Proc Natl Acad Sci U S A. 1992 May 1;89(9):3691–3695. doi: 10.1073/pnas.89.9.3691. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Linet M. S., Harlow S. D., McLaughlin J. K. A case-control study of multiple myeloma in whites: chronic antigenic stimulation, occupation, and drug use. Cancer Res. 1987 Jun 1;47(11):2978–2981. [PubMed] [Google Scholar]
  11. Linet M. S., Stewart W. F., Van Natta M. L., McCaffrey L. D., Szklo M. Comparison of methods for determining occupational exposure in a case-control interview study of chronic lymphocytic leukemia. J Occup Med. 1987 Feb;29(2):136–141. [PubMed] [Google Scholar]
  12. Maher V. E., Gill L., Townes P. L., Wallace J. E., Savas L., Woda B. A., Ansell J. E. Simultaneous chronic lymphocytic leukemia and chronic myelogenous leukemia. Evidence of a separate stem cell origin. Cancer. 1993 Mar 15;71(6):1993–1997. doi: 10.1002/1097-0142(19930315)71:6<1993::aid-cncr2820710612>3.0.co;2-6. [DOI] [PubMed] [Google Scholar]
  13. Malone K. E., Koepsell T. D., Daling J. R., Weiss N. S., Morris P. D., Taylor J. W., Swanson G. M., Lyon J. L. Chronic lymphocytic leukemia in relation to chemical exposures. Am J Epidemiol. 1989 Dec;130(6):1152–1158. doi: 10.1093/oxfordjournals.aje.a115442. [DOI] [PubMed] [Google Scholar]
  14. McKinney P. A., Roberts B. E., O'Brien C., Bird C. C., Richards I. D., Alexander F., Cartwright R. A. Chronic myeloid leukaemia in Yorkshire: a case control study. Acta Haematol. 1990;83(1):35–38. doi: 10.1159/000205160. [DOI] [PubMed] [Google Scholar]
  15. Morris P. D., Koepsell T. D., Daling J. R., Taylor J. W., Lyon J. L., Swanson G. M., Child M., Weiss N. S. Toxic substance exposure and multiple myeloma: a case-control study. J Natl Cancer Inst. 1986 Jun;76(6):987–994. [PubMed] [Google Scholar]
  16. Paustenbach D. J., Price P. S., Ollison W., Blank C., Jernigan J. D., Bass R. D., Peterson H. D. Reevaluation of benzene exposure for the Pliofilm (rubberworker) cohort (1936-1976). J Toxicol Environ Health. 1992 Jul;36(3):177–231. doi: 10.1080/15287399209531633. [DOI] [PubMed] [Google Scholar]
  17. Paxton M. B., Chinchilli V. M., Brett S. M., Rodricks J. V. Leukemia risk associated with benzene exposure in the pliofilm cohort. II. Risk estimates. Risk Anal. 1994 Apr;14(2):155–161. doi: 10.1111/j.1539-6924.1994.tb00040.x. [DOI] [PubMed] [Google Scholar]
  18. Paxton M. B., Chinchilli V. M., Brett S. M., Rodricks J. V. Leukemia risk associated with benzene exposure in the pliofilm cohort: I. Mortality update and exposure distribution. Risk Anal. 1994 Apr;14(2):147–154. doi: 10.1111/j.1539-6924.1994.tb00039.x. [DOI] [PubMed] [Google Scholar]
  19. Rinsky R. A., Smith A. B., Hornung R., Filloon T. G., Young R. J., Okun A. H., Landrigan P. J. Benzene and leukemia. An epidemiologic risk assessment. N Engl J Med. 1987 Apr 23;316(17):1044–1050. doi: 10.1056/NEJM198704233161702. [DOI] [PubMed] [Google Scholar]
  20. Rinsky R. A., Young R. J., Smith A. B. Leukemia in benzene workers. Am J Ind Med. 1981;2(3):217–245. doi: 10.1002/ajim.4700020305. [DOI] [PubMed] [Google Scholar]
  21. Torres A., Giralt M., Raichs A. Coexistencia de antecedentes benzólicos crónicos y plasmocitoma múltiple. Presentación de dos casos. Sangre (Barc) 1970;15(2):275–279. [PubMed] [Google Scholar]
  22. Vigliani E. C. Leukemia associated with benzene exposure. Ann N Y Acad Sci. 1976;271:143–151. doi: 10.1111/j.1749-6632.1976.tb23103.x. [DOI] [PubMed] [Google Scholar]
  23. Wong O. An industry wide mortality study of chemical workers occupationally exposed to benzene. I. General results. Br J Ind Med. 1987 Jun;44(6):365–381. doi: 10.1136/oem.44.6.365. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Wong O. An industry wide mortality study of chemical workers occupationally exposed to benzene. II. Dose response analyses. Br J Ind Med. 1987 Jun;44(6):382–395. doi: 10.1136/oem.44.6.382. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Wong O., Harris F., Smith T. J. Health effects of gasoline exposure. II. Mortality patterns of distribution workers in the United States. Environ Health Perspect. 1993 Dec;101 (Suppl 6):63–76. doi: 10.1289/ehp.93101s663. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Occupational and Environmental Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES