Abstract

The epidemiologic literature on benzene exposure and leukemia in the MEDLINE and TOXNET databases was examined through October 2004 using the keywords “benzene”, “leukemia” and “adverse health effects”. This search was complemented by reviewing the reference lists from extant literature reviews and criteria documents on benzene. Published studies were characterized according to the type of industry studied and design, exposure assessment, disease classification, and control for confounding variables. Study design consisted of either cohort studies or case-control studies, which were further categorized into population-based and nested case-control studies. Disease classification considered the source of diagnostic information, whether there was clinical confirmation from medical records or histopathological, morphological and/or cytogenetic reviews, and as to whether the International Classification of Diseases (ICD) or the French–American–British (FAB) schemes were used (no studies used the Revised European–American Lymphoma (REAL) classification scheme). Nine cohort and 13 case-control studies met inclusion criteria for this review. High and significant acute myeloid leukemia risks with positive dose response relationships were identified across study designs, particularly in the “well-conducted” cohort studies and especially in more highly exposed workers in rubber, shoe, and paint industries. Risks for chronic lymphocytic leukemia (CLL) tended to show elevations in nested case-control studies, with possible dose response relationships in at least two of the three studies. However, cohort studies on CLL show no such risks. Data for chronic myeloid leukemia and acute lymphocytic leukemia are sparse and inconclusive.

Keywords: Benzene; Acute myeloid leukemia (AML); Chronic myeloid leukemia (CML); Acute lymphocytic leukemia (ALL); Chronic lymphocytic leukemia (CLL); Case-control; Cohort

Article Outline

1. Introduction

2. Methods

2.1. Search and inclusion criteria

3. Results

4. Discussion

Appendix A. Estimation and selection procedures according to study

A.1. Aksoy et al. [10]

A.2. Ciccone et al. [30]

A.3. Collins et al. [16]

A.4. Crump [24]

A.5. DeCoufle et al. [25]

A.6. Flodin [32]

A.7. Glass et al. [17]

A.8. Guenel et al. [33]

A.9. Hayes et al. [19]

A.10. Linet et al. [34]

A.11. Linos et al. [35]

A.12. Lynge et al. [26]

A.13. Malone et al. [36]

A.14. Mele et al. [37]

A.15. Richardson et al. [38]

A.16. Rushton et al. [18]

A.17. Tsai et al. [27]

A.18. Vigliani et al. [9]

References