title: Risk of acute myeloid leukaemia and multiple myeloma in workers exposed to benzene.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Applied Health Sciences, San Mateo, California 94401, USA.
authors.forename: O
authors.initials: O
authors.lastname: Wong
mesh_terms: D000208:Acute Disease; D001554:Benzene / Q000009:adverse effects*; D015331:Cohort Studies; D016001:Confidence Intervals; D006801:Humans; D007951:Leukemia, Myeloid / Q000139:chemically induced* / Q000401:mortality; D009101:Multiple Myeloma / Q000139:chemically induced* / Q000401:mortality; D009784:Occupational Diseases / Q000139:chemically induced* / Q000401:mortality; D016273:Occupational Exposure; D009820:Ohio / Q000453:epidemiology; D012307:Risk Factors
chemical_list: D001554:Benzene