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苯暴露所致白血病风险定量评估背后的一致性与不一致性。

Consistencies and inconsistencies underlying the quantitative assessment of leukemia risk from benzene exposure.

作者信息

Lamm S H, Walters A S, Wilson R, Byrd D M, Grunwald H

机构信息

Consultants in Epidemiology and Occupational Health, Inc., Washington, DC 20007.

出版信息

Environ Health Perspect. 1989 Jul;82:289-97. doi: 10.1289/ehp.8982289.

Abstract

This paper examines recent risk assessments for benzene and observes a number of inconsistencies within the study and consistencies between studies that should effect the quantitative determination of the risk from benzene exposure. Comparisons across studies show that only acute myeloid leukemia (AML) is found to be consistently in excess with significant benzene exposure. The data from the Pliofilm study that forms the basis of most quantitative assessments reveal that all the AML cases came from only one of the three studied plants and that all the benzene exposure data came from the other plants. Hematological data from the 1940s from the plant from which almost all of the industrial hygiene exposure data come do not correlate well with the originally published exposure estimates but do correlate well with an alternative set of exposure estimates that are much greater than those estimates originally published. Temporal relationships within the study are not consistent with those of other studies. The dose-response relationship is strongly nonlinear. Other data suggest that the leukemogenic effect of benzene is nonlinear and may derive from a threshold toxicity.

摘要

本文研究了近期对苯的风险评估,并观察到该研究内部存在一些不一致之处,以及不同研究之间的一致性,这些应会影响从苯暴露定量确定风险。跨研究比较表明,仅发现急性髓系白血病(AML)在苯大量暴露时持续出现超额情况。构成大多数定量评估基础的普利菲姆研究数据显示,所有AML病例仅来自三个研究工厂中的一个,而所有苯暴露数据则来自其他工厂。几乎所有工业卫生暴露数据所源自工厂的20世纪40年代血液学数据,与最初公布的暴露估计值相关性不佳,但与另一组远高于最初公布估计值的替代暴露估计值相关性良好。该研究中的时间关系与其他研究不一致。剂量反应关系呈强非线性。其他数据表明,苯的致白血病作用是非线性的,可能源于阈值毒性。

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本文引用的文献

1
BENZENE AND LEUKEMIA.苯与白血病
N Engl J Med. 1964 Oct 22;271:872-6. doi: 10.1056/NEJM196410222711703.
2
Selected epidemiologic observations of cell-specific leukemia mortality in the United States, 1969-1977.
Am J Epidemiol. 1983 Feb;117(2):140-52. doi: 10.1093/oxfordjournals.aje.a113524.
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Benzene and leukemia. An epidemiologic risk assessment.苯与白血病。一项流行病学风险评估。
N Engl J Med. 1987 Apr 23;316(17):1044-50. doi: 10.1056/NEJM198704233161702.
9
Hematologic effects of benzene: a thirty-five year longitudinal study of rubber workers.
Toxicol Ind Health. 1988 Dec;4(4):411-30. doi: 10.1177/074823378800400401.

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