{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:06:07Z","timestamp":1789020367044,"version":"build-2803163510"},"reference-count":22,"publisher":"BMJ","issue":"9","funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["N.A."],"award-info":[{"award-number":["N.A."]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Occup Environ Med"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Benzene is a known haematoxin and leukemogen that can cause benzene poisoning (BP), that is, a persistent reduction in white cell counts that is strongly associated with increased risk of lymphohaematopoietic malignancies. Data are needed on the exposure\u2013response, particularly at low doses and susceptible populations for clinical and regulatory purposes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a case-cohort study among 110\u2009631 Chinese workers first employed 1949\u20131987 and followed up during 1972\u20131999, we evaluated BP risk according to benzene exposure level and investigated risk modification by subject (sex, attained age) and exposure-related factors (latency, exposure windows, age at first benzene exposure, coexposure to toluene) using excess relative risk and excess absolute risk models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 538\u2009BP cases and 909 benzene-exposed referents. The exposure metric with best model fit was cumulative benzene exposure during a 5-year risk window, followed by a 9-month lag period before BP diagnosis. Estimated excess absolute risk of BP at age 60 increased from 0.5% for subjects in the lowest benzene exposure category (&gt;0 to 10 ppm-years) to 5.0% for those in the highest category (&gt;100 ppm-years) compared with unexposed subjects. Increased risks were apparent at low cumulative exposure levels and for workers who were first exposed at &lt;30\u2009years of age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our data show a clear association between benzene exposure and BP, beginning at low cumulative benzene exposure levels with no threshold, and with higher risks for workers exposed at younger ages. These findings are important because BP has been linked to a strongly increased development of lymphohaematopoietic malignancies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/oemed-2021-108155","type":"journal-article","created":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T13:25:50Z","timestamp":1646918750000},"page":"610-617","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Benzene exposure and risk of benzene poisoning in Chinese workers"],"prefix":"10.1136","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4082-8163","authenticated-orcid":false,"given":"Roel","family":"Vermeulen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00fctzen","family":"Portengen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethel S","family":"Gilbert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3985-2935","authenticated-orcid":false,"given":"Gra\u00e7a M","family":"Dores","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bu-Tian","family":"Ji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Hayes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sognian","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel","family":"Rothman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha S","family":"Linet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Lan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,3,10]]},"reference":[{"key":"2023100119250974000_79.9.610.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30832-X"},{"key":"2023100119250974000_79.9.610.2","first-page":"2839","article-title":"Benzene poisoning, a risk factor for hematological malignancy, is associated with the NQO1 609C-->T mutation and rapid fractional excretion of chlorzoxazone","volume":"57","author":"Rothman","year":"1997","journal-title":"Cancer Res"},{"key":"2023100119250974000_79.9.610.3","first-page":"1343","article-title":"Indirect validation of benzene exposure assessment by association with benzene poisoning","volume":"104(Suppl 6)","author":"Dosemeci","year":"1996","journal-title":"Environ Health Perspect"},{"key":"2023100119250974000_79.9.610.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2005.08.019"},{"key":"2023100119250974000_79.9.610.5","first-page":"296","article-title":"Haematological effects of chronic benzene poisoning in 217 workers","volume":"28","author":"Aksoy","year":"1971","journal-title":"Br J Ind Med"},{"key":"2023100119250974000_79.9.610.6","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.29591"},{"key":"2023100119250974000_79.9.610.7","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1093\/jnci\/djy143","article-title":"Benzene exposure response and risk of myeloid neoplasms in Chinese workers: a multicenter case-cohort study","volume":"111","author":"Linet","year":"2019","journal-title":"J Natl Cancer Inst"},{"key":"2023100119250974000_79.9.610.8","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1038\/jes.2015.44","article-title":"Retrospective benzene exposure assessment for a multi-center case-cohort study of benzene-exposed workers in China","volume":"26","author":"Portengen","year":"2016","journal-title":"J Expo Sci Environ Epidemiol"},{"key":"2023100119250974000_79.9.610.9","unstructured":"Langholz B , Jiao J . 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