title: A retrospective cohort study of cause-specific mortality and incidence of hematopoietic malignancies in Chinese benzene-exposed workers.
abstract: Benzene exposure has been causally linked with acute myeloid leukemia (AML), but inconsistently associated with other hematopoietic, lymphoproliferative and related disorders (HLD) or solid tumors in humans. Many neoplasms have been described in experimental animals exposed to benzene. We used Poisson regression to estimate adjusted relative risks (RR) and the likelihood ratio statistic to derive confidence intervals for cause-specific mortality and HLD incidence in 73,789 benzene-exposed compared with 34,504 unexposed workers in a retrospective cohort study in 12 cities in China. Follow-up and outcome assessment was based on factory, medical and other records. Benzene-exposed workers experienced increased risks for all-cause mortality (RR = 1.1, 95% CI = 1.1, 1.2) due to excesses of all neoplasms (RR = 1.3, 95% CI = 1.2, 1.4), respiratory diseases (RR = 1.7, 95% CI = 1.2, 2.3) and diseases of blood forming organs (RR = ∞, 95% CI = 3.4, ∞). Lung cancer mortality was significantly elevated (RR = 1.5, 95% CI = 1.2, 1.9) with similar RRs for males and females, based on three-fold more cases than in our previous follow-up. Significantly elevated incidence of all myeloid disorders reflected excesses of myelodysplastic syndrome/acute myeloid leukemia (RR = 2.7, 95% CI = 1.2, 6.6) and chronic myeloid leukemia (RR = 2.5, 95% CI = 0.8, 11), and increases of all lymphoid disorders included excesses of non-Hodgkin lymphoma (RR = 3.9, 95%CI = 1.5, 13) and all lymphoid leukemia (RR = 5.4, 95%CI = 1.0, 99). The 28-year follow-up of Chinese benzene-exposed workers demonstrated increased risks of a broad range of myeloid and lymphoid neoplasms, lung cancer, and respiratory diseases and suggested possible associations with other malignant and non-malignant disorders.
authors.affiliation: Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD.
authors.forename: Martha S
authors.initials: MS
authors.lastname: Linet
authors.affiliation: National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Song-Nian
authors.initials: SN
authors.lastname: Yin
authors.affiliation: Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD.
authors.forename: Ethel S
authors.initials: ES
authors.lastname: Gilbert
authors.affiliation: Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD.
authors.forename: Graça M
authors.initials: GM
authors.lastname: Dores
authors.affiliation: Division of Epidemiology, Department of Population Health, New York University School of Medicine, New York, NY.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Hayes
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
authors.forename: Roel
authors.initials: R
authors.lastname: Vermeulen
authors.affiliation: National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Hao-Yuan
authors.initials: HY
authors.lastname: Tian
authors.affiliation: Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD.
authors.forename: Qing
authors.initials: Q
authors.lastname: Lan
authors.affiliation: Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
authors.forename: Lutzen
authors.initials: L
authors.lastname: Portengen
authors.affiliation: Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD.
authors.forename: Bu-Tian
authors.initials: BT
authors.lastname: Ji
authors.affiliation: National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Gui-Lan
authors.initials: GL
authors.lastname: Li
authors.affiliation: Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD.
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Rothman
mesh_terms: D000328:Adult; D000368:Aged; D000395:Air Pollutants, Occupational / Q000633:toxicity*; D001554:Benzene / Q000633:toxicity*; D002273:Carcinogens / Q000633:toxicity*; D005260:Female; D019337:Hematologic Neoplasms / Q000139:chemically induced / Q000401:mortality*; D006801:Humans; D015994:Incidence; D016013:Likelihood Functions; D008175:Lung Neoplasms / Q000139:chemically induced / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D000395:Air Pollutants, Occupational; D002273:Carcinogens; D001554:Benzene
keywords: benzene; leukemia; lung cancer; lymphoma; mortality