Jardel Hanna V, Keil Alexander P, Martin Chantel L, Richardson David B, Stenzel Mark R, Stewart Patricia A, Christenbury Kate E, Engel Lawrence S, Sandler Dale P
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
Occupational and Environmental Epidemiology Branch, National Cancer Institute Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA.
Environ Res. 2025 Jul 1;276:121487. doi: 10.1016/j.envres.2025.121487. Epub 2025 Mar 26.
Exposure to benzene, toluene, ethylbenzene, xylenes, and n-hexane (BTEX-H) may contribute to the development of diabetes. Oil spill response and cleanup (OSRC) workers are exposed to BTEX-H but there are few relevant studies. We studied incident diabetes over 10 years of follow-up among OSRC workers.
This analysis includes 21,726 participants (82.2 % male, mean age 39.9 years; 66.5 % White race) in the Gulf Long-term Follow-up Study - a prospective cohort of Deepwater Horizon (DWH) oil spill OSRC workers followed from 2011 to 2013 through 2021. Individual estimates of cumulative work-related exposures to specific BTEX-H chemicals and an aggregate sum (total BTEX-H) were derived from a job-exposure matrix that linked exposure group estimates derived from exposure measurements to self-reported DWH work histories. We used Cox models to estimate associations of quartiles of exposure to individual BTEX-H chemicals and total BTEX-H with diabetes incidence. We used quantile-based g-computation, quantifying associations with exposure to the BTEX-H chemicals, treating them as separate components in a mixture. We examined differences in associations by neighborhood disadvantage using the Area Deprivation Index (ADI) and by self-classified race in stratified analyses.
Exposure to the BTEX-H chemicals was associated with diabetes, with elevated hazard ratios for third and fourth quartiles of exposure compared to the first quartile. For example, total BTEX-H, Q3 and Q4 HRs were 1.10 95 %CI (0.91, 1.33) and 1.27 95 %CI (1.05, 1.53), respectively. The HR associated with a three-quartile increase in the BTEX-H mixture was 1.31 95 %CI (1.07, 1.59). Stratified analyses showed little variation by race and suggestions of variation by ADI.
Exposures to BTEX-H chemicals were associated with incident diabetes among OSRC workers for the individual BTEX-H chemicals, total BTEX-H, and the BTEX-H mixture. The range of exposures in this study make these findings relevant to other low to moderate exposure settings.
接触苯、甲苯、乙苯、二甲苯和正己烷（BTEX-H）可能会导致糖尿病的发生。石油泄漏应急与清理（OSRC）工作人员会接触到BTEX-H，但相关研究较少。我们对OSRC工作人员进行了为期10年的随访，以研究糖尿病的发病情况。
本分析纳入了海湾长期随访研究中的21,726名参与者（82.2%为男性，平均年龄39.9岁；66.5%为白人），这是一个对深水地平线（DWH）石油泄漏OSRC工作人员的前瞻性队列研究，从2011年至2013年随访至2021年。通过将从接触测量得出的接触组估计值与自我报告的DWH工作经历相联系的工作接触矩阵，得出了特定BTEX-H化学物质的累积工作相关接触的个体估计值以及总和（总BTEX-H）。我们使用Cox模型来估计个体BTEX-H化学物质和总BTEX-H暴露四分位数与糖尿病发病率之间的关联。我们使用基于分位数的g计算方法，量化与BTEX-H化学物质暴露的关联，将它们视为混合物中的单独成分。我们在分层分析中使用区域剥夺指数（ADI）研究邻里劣势和自我分类种族对关联的差异。
接触BTEX-H化学物质与糖尿病有关，与第一四分位数相比，第三和第四四分位数的暴露风险比升高。例如，总BTEX-H，第三四分位数和第四四分位数的风险比分别为1.10 95%置信区间（0.91, 1.33）和1.27 95%置信区间（1.05, 1.53）。与BTEX-H混合物增加三个四分位数相关的风险比为1.31 95%置信区间（1.07, 1.59）。分层分析显示种族差异不大，而ADI存在差异迹象。
对于个体BTEX-H化学物质、总BTEX-H和BTEX-H混合物，OSRC工作人员接触BTEX-H化学物质与糖尿病发病有关。本研究中的接触范围使这些发现与其他低至中度接触情况相关。
