title: Hematotoxicity among Chinese workers heavily exposed to benzene.
abstract: Benzene is a well-established hematotoxin. However, reports of its effects on specific blood cells have been somewhat inconsistent and the relative toxicity of benzene metabolites on peripheral blood cells in humans has not been evaluated. We compared hematologic outcomes in a cross-sectional study of 44 workers heavily exposed to benzene (median: 31 parts permillion [ppm] as an 8-hr time-weighted average [TWA] and 44 age and gender-matched unexposed controls from Shanghai, China. All hematologic parameters (total white blood cells [WBC], absolute lymphocyte count, platelets, red blood cells, and hematocrit) were decreased among exposed workers compared to controls, with the exception of the red blood cell mean corpuscular volume (MCV), which was higher among exposed subjects. In a subgroup of workers who were not exposed to more than 31 ppm benzene on any of 5 sampling days (n = 11, median 8 hr TWA = 7.6 ppm, range = 1-20 ppm), only the absolute lymphocyte count was significantly different between exposed workers (mean [sd]1.6 [0.4] x 10(3) mu L) and controls (1.9 [0.4] x l0(3) uL, p = 0.03). Among exposed subjects, a dose response relationship with various measures of current benzene exposure (i.e., personal air monitoring, benzene metabolites in urine) was present only for the total WBC count, the absolute lymphocyte count, and the MCV. Correlations between benzene metabolites and hematologic parameters were generally similar, although hydroquinone was somewhat more strongly associated with a decrease in the absolute lymphocyte count, and catechol was more strongly associated with an increase in MCV. Morphologic review of peripheral blood slides demonstrated an excess of red blood cell abnormalities (i.e., stomatocytes and target cells) only in the most heavily exposed workers, with no differences in granulocyte, lymphocyte, or platelet morphology noted. Although benzene can affect all the major peripheral blood elements, our results support the use of the absolute lymphocyte count as the most sensitive indicator of benzene-induced hematotoxicity.
authors.affiliation: Chinese Academy of Preventive Medicine, Institute of Occupational Medicine, Beijing, China.
authors.forename: N
authors.initials: N
authors.lastname: Rothman
authors.forename: G L
authors.initials: GL
authors.lastname: Li
authors.forename: M
authors.initials: M
authors.lastname: Dosemeci
authors.forename: W E
authors.initials: WE
authors.lastname: Bechtold
authors.forename: G E
authors.initials: GE
authors.lastname: Marti
authors.forename: Y Z
authors.initials: YZ
authors.lastname: Wang
authors.forename: M
authors.initials: M
authors.lastname: Linet
authors.forename: L Q
authors.initials: LQ
authors.lastname: Xi
authors.forename: W
authors.initials: W
authors.lastname: Lu
authors.forename: M T
authors.initials: MT
authors.lastname: Smith
authors.forename: N
authors.initials: N
authors.lastname: Titenko-Holland
authors.forename: L P
authors.initials: LP
authors.lastname: Zhang
authors.forename: W
authors.initials: W
authors.lastname: Blot
authors.forename: S N
authors.initials: SN
authors.lastname: Yin
authors.forename: R B
authors.initials: RB
authors.lastname: Hayes
mesh_terms: D000328:Adult; D017677:Age Distribution; D001554:Benzene / Q000009:adverse effects*; D001772:Blood Cell Count; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004784:Environmental Monitoring; D062665:Epidemiological Monitoring; D005260:Female; D006402:Hematologic Diseases / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D016273:Occupational Exposure / Q000009:adverse effects* / Q000032:analysis; D012016:Reference Values; D012307:Risk Factors; D017678:Sex Distribution
chemical_list: D001554:Benzene