Dohsbase, a comprehensive database with hierarchical information on phys-chem, health hazard info, OELVs, sampling methods and risk ranking of chemicals used in the workplace.
Benzene and Leukemia.
A retrospective cohort study among 311 Dutch workers employed in a HSO/Caprolactam
production facility exposed to pure benzene (IARC Group 1 carcinogen) between 1951 and 1968.
Observations and analysis: 1% lost to follow-up. Mortality
39%. Overall Standardized Mortality Ratio (SMR) 85.9% (95% CI: 71.3-102.6%).
Of 275 cohort members, exposure could be quantified, resulting in 43,725 ppm-years.
One leukaemia case (non-acute myeloid) was observed in the second of three exposure categories, compared with 1.17 expected.
3.3 and 7.5 Additional leukaemia cases predicted by extreme benzene risk
models (Austin, 1988 ; Rinsky, 1981) were rejected with probabilities due
to chance of 0.03 and 0.0001 respectively.
Conclusion: The absence of leukaemia excess deaths in this cohort
with long-term benzene exposure levels of 0.5-20 ppm per day, 159 ppm-years
(520 mg/m3-years) per worker on the average, is consistent with the ECHA/RAC
(2018) mode-of-action-based threshold approach for benzene-induced leukaemia.
Strengths: a well-defined industrial cohort with stable employment, lower overall mortality, and pure benzene exposure. A predefined research protocol and separated assessment of individual exposure and cause of death reduce the risk of observer bias, data dredging and post hoc manipulation of the dose-response.
The relatively high baseline health status, access to healthcare and lifestyle factors in the wealthy coal area in the Netherlands may have contributed to differences in observed risk estimates compared to other benzene cohorts.
Limitations: the cause of death was unknown for 5 of the 121 deaths, and cumulative exposure data were unavailable for 36 workers.
Noteworthy finding: a statistically significant excess of brain tumours was observed (6 cases versus 0.95 expected), a finding that has also been reported in industrial cohorts from countries with developed healthcare systems.