Table 23 Types of cancers reported following exposure to benzene

The role of benzene in some of these cancers is controversial, see text for details.

Acute lymphoblastic leukaemia (ALL)

Acute myelogenous leukaemia (AML) acute myeloblastic leukaemia acute myelomonocytic leukaemia

Chronic myelogenous leukaemia (CML)

Erythomyelosis

Erythroleukaemia

Hodgkin's disease

Lung cancer

Malignant lymphoma

Multiple myeloma

Non-Hodgkin's lymphoma (NHL; lymphosarcoma)

Note: The terms acute and chronic do not refer to the duration of disease but to the degree of cell differentiation, i.e., little or none and well differentiated, respectively.

Some mortality studies on benzene exposure have identified individuals with lung cancer (Aksoy, 1985; Yin et al., 1989; Hayes et al., 1996; Yin et al., 1996). However, the relative risk of lung cancer from benzene exposure is difficult to distinguish from the risks associated with cigarette smoking.

Some studies on benzene exposure and leukaemia have coincidentally shown an increase in the relative risk of lymphoma, including Hodgkin's disease and non-Hodgkin's lymphoma (Vianna and Polan, 1979; Decoufle et al., 1983; Rinsky et al., 1987; Wong, 1987a; Yin et al., 1996). More studies are required to determine whether benzene exposure does increase the risk of lymphoma (Young, 1989). Increasing environmental benzene concentrations may have a role in the increased incidence of non-Hodgkin's lymphoma (O'Connor et al., 1999).

• Multiple myeloma

Multiple myeloma, which is characterised by multiple bone marrow tumours, has been reported in workers exposed to benzene, both in case reports (Torres et al., 1970; Aksoy et al., 1984) and in epidemiological studies (Decoufle et al., 1983; Rinsky et al., 1987; Rinsky 1989). However, benzene exposure and the association with an increased risk of multiple myeloma is a controversial subject (Bergsagel et al., 2000; Goldstein and Shalat, 2000). Several studies using analysis of raw data (Bond et al., 1986; Wong, 1987a,b; Yin et al., 1996; Paci et al., 1989), published cohort data (Bezabeh et al., 1996, Wong and Raabe, 1997), updating previous cohort studies (Paxton et al., 1994a; Paxton, 1996) and evaluation of the literature (Bergsagel et al., 1999) have found no association.

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