Bogadi-Sare Ana, Zavalić Marija, Turk Rajka
Croatian Institute of Occupational Health, Division for Occupational Diseases and Industrial Toxicology, Zagreb, Croatia.
Am J Ind Med. 2003 Nov;44(5):467-73. doi: 10.1002/ajim.10296.
A medical surveillance program of benzene-exposed workers has to be established in such a way as to observe early signs of benzene-induced cytopenia, pancytopenia, or leukemia. This study evaluates the utility of routine medical survey applied to benzene-exposed workers by analyzing the hematological, immunological, and cytogenetic assay results.
The results of a previous study of hematological, immunological, and cytogenetic assays in benzene-exposed workers (up to 15 ppm) are used to discuss medical surveillance program by defining the relationship between various benzene exposure concentrations and toxic endpoints.
Exposure to benzene concentration lower than 5 ppm does not produce any abnormal hematological measurements. For benzene cumulative exposure above 100 (ppm-years), some blood indices [mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), band neutrophils] show significant differences in comparison to the control group. The incidence of dicentric chromosomes was higher and the level of B-lymphocytes was lower even with workers exposed to 5 ppm of benzene; correlation with exposure indicators was not found.
The results suggest that peripheral blood indices, although not sensitive enough, are still the most suitable parameters in a health surveillance program applied to benzene-exposed workers. B-lymphocytes could be a promising indicator of the benzene-induced damage. Cytogenetic tests did not prove to be suitable. Further investigation of useful screening tests for health surveillance program of benzene-exposed workers is still required.
必须建立一项针对苯接触工人的医学监测计划,以便观察苯诱导的血细胞减少、全血细胞减少或白血病的早期迹象。本研究通过分析血液学、免疫学和细胞遗传学检测结果,评估应用于苯接触工人的常规医学检查的效用。
通过定义各种苯暴露浓度与毒性终点之间的关系,利用先前对苯接触工人(暴露浓度高达15 ppm)进行血液学、免疫学和细胞遗传学检测的研究结果来讨论医学监测计划。
接触低于5 ppm的苯浓度不会产生任何异常血液学测量结果。对于累积苯暴露超过100(ppm-年)的情况,一些血液指标[平均红细胞体积(MCV)、平均红细胞血红蛋白浓度(MCHC)、带状中性粒细胞]与对照组相比显示出显著差异。即使是接触5 ppm苯的工人,双着丝粒染色体的发生率也较高,而B淋巴细胞水平较低;未发现与暴露指标的相关性。
结果表明,外周血指标虽然不够敏感,但仍是应用于苯接触工人的健康监测计划中最合适的参数。B淋巴细胞可能是苯诱导损伤的一个有前景的指标。细胞遗传学检测并不适用。仍需要进一步研究适用于苯接触工人健康监测计划的有用筛查测试。