A hematology surveillance study of petrochemical workers exposed to benzene

Historically, complete blood counts (CBCs) have been recognized as an easy and readily available screen for hematotoxicity following occupational exposure to benzene. The purpose of this study is to evaluate hematology data from employees who have ever participated in the Shell Benzene Medical Surveillance Program (BMSP) compared to employees who have not participated and to examine the sensitivity of CBCs to detect hematological changes in a low-exposure occupational setting. This large study included 1200 employees who participated in the BMSP, with mean benzene exposure (TWA-8) of 0.60 ppm from 1977 to 1988 and 0.14 ppm since 1988, and 3227 comparison employees. The comparison group included employees not enrolled in either the benzene or butadiene surveillance programs. Abnormality of six CBC parameters and the adjusted mean values of these parameters in the exposed group were compared with that of the comparison group. We found no increased abnormality for any hematology parameter among exposed employees. The adjusted mean values (adjusted for age, sex, race, length of time between first and last exam, and current smoking status) of the exposed employees were similar to those in the comparison group. At current occupational exposure levels for benzene, no evidence of adverse hematological effects was observed in this study. These results raise the question of whether annual CBC surveillance for benzene-exposed workers has adequate sensitivity to detect meaningful hematological changes due to low-level exposures.