Rothman N, Li G L, Dosemeci M, Bechtold W E, Marti G E, Wang Y Z, Linet M, Xi L Q, Lu W, Smith M T, Titenko-Holland N, Zhang L P, Blot W, Yin S N, Hayes R B
Chinese Academy of Preventive Medicine, Institute of Occupational Medicine, Beijing, China.
Am J Ind Med. 1996 Mar;29(3):236-46. doi: 10.1002/(SICI)1097-0274(199603)29:3<236::AID-AJIM3>3.0.CO;2-O.
Benzene is a well-established hematotoxin. However, reports of its effects on specific blood cells have been somewhat inconsistent and the relative toxicity of benzene metabolites on peripheral blood cells in humans has not been evaluated. We compared hematologic outcomes in a cross-sectional study of 44 workers heavily exposed to benzene (median: 31 parts permillion [ppm] as an 8-hr time-weighted average [TWA] and 44 age and gender-matched unexposed controls from Shanghai, China. All hematologic parameters (total white blood cells [WBC], absolute lymphocyte count, platelets, red blood cells, and hematocrit) were decreased among exposed workers compared to controls, with the exception of the red blood cell mean corpuscular volume (MCV), which was higher among exposed subjects. In a subgroup of workers who were not exposed to more than 31 ppm benzene on any of 5 sampling days (n = 11, median 8 hr TWA = 7.6 ppm, range = 1-20 ppm), only the absolute lymphocyte count was significantly different between exposed workers (mean [sd]1.6 [0.4] x 10(3) mu L) and controls (1.9 [0.4] x l0(3) uL, p = 0.03). Among exposed subjects, a dose response relationship with various measures of current benzene exposure (i.e., personal air monitoring, benzene metabolites in urine) was present only for the total WBC count, the absolute lymphocyte count, and the MCV. Correlations between benzene metabolites and hematologic parameters were generally similar, although hydroquinone was somewhat more strongly associated with a decrease in the absolute lymphocyte count, and catechol was more strongly associated with an increase in MCV. Morphologic review of peripheral blood slides demonstrated an excess of red blood cell abnormalities (i.e., stomatocytes and target cells) only in the most heavily exposed workers, with no differences in granulocyte, lymphocyte, or platelet morphology noted. Although benzene can affect all the major peripheral blood elements, our results support the use of the absolute lymphocyte count as the most sensitive indicator of benzene-induced hematotoxicity.
苯是一种公认的血液毒素。然而，关于其对特定血细胞影响的报告在一定程度上并不一致，并且苯代谢物对人类外周血细胞的相对毒性尚未得到评估。我们在中国上海进行了一项横断面研究，比较了44名重度接触苯的工人（中位数：8小时时间加权平均浓度为31 ppm）与44名年龄和性别匹配的未接触对照者的血液学结果。与对照组相比，接触组工人的所有血液学参数（白细胞总数、绝对淋巴细胞计数、血小板、红细胞和血细胞比容）均降低，但红细胞平均体积（MCV）除外，接触组的MCV较高。在一个亚组工人中，他们在5个采样日中的任何一天接触苯的浓度均未超过31 ppm（n = 11，中位数8小时时间加权平均浓度 = 7.6 ppm，范围 = 1 - 20 ppm），接触组工人（平均值[标准差]1.6 [0.4]×10³/μL）与对照组（1.9 [0.4]×10³/μL，p = 0.03）之间仅绝对淋巴细胞计数有显著差异。在接触组受试者中，仅白细胞总数、绝对淋巴细胞计数和MCV与当前苯接触的各种测量指标（即个人空气监测、尿中苯代谢物）存在剂量反应关系。苯代谢物与血液学参数之间的相关性总体相似，尽管对苯二酚与绝对淋巴细胞计数降低的相关性稍强，儿茶酚与MCV升高的相关性更强。对外周血涂片的形态学检查显示，仅在接触程度最重的工人中出现红细胞异常（即口形红细胞和靶形细胞）过多，而粒细胞、淋巴细胞或血小板形态无差异。虽然苯可影响所有主要外周血细胞成分，但我们的结果支持将绝对淋巴细胞计数作为苯诱导血液毒性的最敏感指标。
