Exposure to benzene at work and the risk of leukemia: a systematic review and meta-analysis

Environmental Health

Research

Maritta S Jaakkola¹  Eero Pukkala²  Abdul Khalade³  Jouni JK Jaakkola⁴ 

[1] 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;Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Pieni Roobertinkatu 9, Helsinki, Finland;School of Public Health, University of Tampere, Tampere, Finland;Institute of Occupational and Environmental Medicine, University of Birmingham, UK;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;

关键词: Acute Myeloid Leukemia;    Acute Lymphocytic Leukemia;    Chronic Lymphocytic Leukemia;    Chronic Myeloid Leukemia;    Effect Estimate;   

DOI  :  10.1186/1476-069X-9-31

 received in 2009-08-19, accepted in 2010-06-28,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundA 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).MethodsA 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).ResultsIn 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.ConclusionsOur 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.

【 授权许可】

Unknown   
© Khalade et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.