Meta-Analysis of Benzene Exposure and Non-Hodgkin Lymphoma: Biases Could Mask an Important Association

Details

• Personal Author:
  Jones RM ; Smith AH ; Smith MT ; Steinmaus C
• Description:
  OBJECTIVES: Benzene is a widely recognised cause of leukaemia but its association with non-Hodgkin's lymphoma (NHL) is less well established. The goal of this project is to review the current published literature on this association. METHODS: We performed a meta-analysis of cohort and case-control studies of benzene exposure and NHL and a meta-analysis of NHL and refinery work, a potential source of benzene exposure. RESULTS: In 22 studies of benzene exposure, the summary relative risk for NHL was 1.22 (95% CI 1.02 to 1.47; one-sided p value = 0.01). When studies that likely included unexposed subjects in the "exposed" group were excluded, the summary relative risk increased to 1.49 (95% CI 1.12 to 1.97, n = 13), and when studies based solely on self-reported work history were excluded, the relative risk rose to 2.12 (95% CI 1.11 to 4.02, n = 6). In refinery workers, the summary relative risk for NHL in all 21 studies was 1.21 (95% CI 1.00 to 1.46; p = 0.02). When adjusted for the healthy worker effect, this relative risk estimate increased to 1.42 (95% CI 1.19 to 1.69). CONCLUSIONS: The finding of elevated relative risks in studies of both benzene exposure and refinery work provides further evidence that benzene exposure causes NHL. In addition, the finding of increased relative risks after removing studies that included unexposed or lesser exposed workers in "exposed" cohorts, and increased relative risk estimates after adjusting for the healthy worker effect, suggest that effects of benzene on NHL might be missed in occupational studies if these biases are not accounted for. [Description provided by NIOSH]
• Subjects:
  Occupational Diseases Occupational Exposure Occupational Health Risk Assessment Risk Factors Safety Workplace
• Keywords:
  Occupational-diseases Occupational-exposure Occupational-hazards Risk-analysis Risk-factors Statistical-analysis Work-environment Worker-health
• ISSN:
  1351-0711
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  371-378
• Volume:
  65
• Issue:
  6
• NIOSHTIC Number:
  nn:20033982
• Citation:
  Occup Environ Med 2008 Jun; 65(6):371-378
• Contact Point Address:
  School of Public Health, University of California, Berkeley, California
• Email:
  craigs@berkeley.edu
• CAS Registry Number:
  Benzene (CAS RN 71-43-2)
• Federal Fiscal Year:
  2008
• Performing Organization:
  University of California, Berkeley
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Occupational and Environmental Medicine
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:b7e55b45d6ef92e2a8271771307c6c8db485d213e5bc4ac18c94b0c7c899128454883880e5732ca16b0fbb21c9f433fc841fb78f067f239712d1184ee16182e1
• Download URL:
  https://stacks.cdc.gov/view/cdc/189375/cdc_189375_DS1.pdf
• File Type:
  [PDF - 254.63 KB ]