Wong Otto, Fu Hua
Applied Health Sciences Inc., 181 Second Avenue, Suite 628, PO Box 2078, San Mateo, CA 94401, USA.
Chem Biol Interact. 2005 May 30;153-154:33-41. doi: 10.1016/j.cbi.2005.03.008. Epub 2005 Apr 7.
The interest in the relationship between benzene exposure and non-Hodgkin lymphoma (NHL) appears to have been generated from a 1979 publication, which reported an increased risk of NHL among persons potentially exposed to benzene and/or coal tar fractions. More recently (1997), an increased risk of NHL was reported among 74,828 workers exposed to benzene and other chemicals in a variety of industries in China. On the contrary, no increased risk of NHL was reported in a cohort of 1,165 workers at two rubber hydrochloride plants in Ohio (US), who were exposed to extremely high levels of benzene and were found to have an increased risk of acute myeloid leukemia. In another large cohort of some 7,676 US workers exposed to benzene, no increased risk of NHL was reported. Similarly, no increased risk of NHL was reported in a combined cohort of 308,199 petroleum workers in the US, the UK, Canada, Australia, Italy and Finland, who were exposed to benzene or benzene-containing petroleum products. The lack of an association between benzene exposure and NHL in cohort studies is supported by case-control studies from the US, Canada, Italy and the UK. To further investigate the relationship between benzene exposure and NHL, we are conducting a hospital-based case-control study in Shanghai, China. Cases are newly diagnosed NHL patients at 29 hospitals in Shanghai. For each case, two matched controls are selected among patients without any lymphatic or hematopoietic diseases at the same hospital. Demographic, employment, medical and lifestyle information is obtained through questionnaires (primary and secondary). Sources for benzene exposure information include a database of 50,000+ benzene measurements maintained by the Shanghai Municipal Institute of Public Health Supervision (IPHS), Shanghai District IPHS, walk-through surveys at factories, additional measurements at factories and reports in Chinese medical journals. Patient enrollment started in 2003 and it is estimated that the study will have 400-450 NHL cases by December 2006. Some of the occupations or industries reported among enrolled study subjects (cases and controls) with potential exposure to benzene include shoe workers, painters, mechanics or machinists, and printers. Some of the unique features of the study are discussed.
对苯接触与非霍奇金淋巴瘤（NHL）之间关系的关注似乎源于1979年发表的一篇文章，该文章报道了在可能接触苯和/或煤焦油馏分的人群中NHL风险增加。最近（1997年），在中国多个行业接触苯和其他化学品的74828名工人中报告了NHL风险增加。相反，在美国俄亥俄州两家盐酸橡胶厂的1165名工人队列中，未报告NHL风险增加，这些工人接触极高水平的苯，且被发现患急性髓系白血病的风险增加。在另一组约7676名接触苯的美国工人中，也未报告NHL风险增加。同样，在美国、英国、加拿大、澳大利亚、意大利和芬兰的308199名接触苯或含苯石油产品的石油工人合并队列中，也未报告NHL风险增加。队列研究中苯接触与NHL之间缺乏关联得到了美国、加拿大、意大利和英国的病例对照研究的支持。为了进一步研究苯接触与NHL之间的关系，我们正在中国上海进行一项基于医院的病例对照研究。病例为上海29家医院新诊断的NHL患者。对于每个病例，在同一家医院无任何淋巴或造血疾病的患者中选择两名匹配对照。通过问卷（初次和二次）获取人口统计学、就业、医疗和生活方式信息。苯接触信息来源包括上海市公共卫生监督所维护的50000多次苯测量数据库、上海各区公共卫生监督所、工厂巡查、工厂额外测量以及中文医学期刊报道。患者招募于2003年开始，预计到2006年12月该研究将有400 - 450例NHL病例。在已登记的研究对象（病例和对照）中报告的一些可能接触苯的职业或行业包括鞋厂工人、油漆工、机械师或机械工人以及印刷工。本文讨论了该研究的一些独特之处。
