{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:54:18Z","timestamp":1792155258580,"version":"4.4.0"},"reference-count":32,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Occup Environ Med"],"accepted":{"date-parts":[[2026,4,16]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:p>Lymphoid neoplasms are a diverse group of cancers derived from lymphocytes, with classification recently updated by the 5th edition of the WHO Classification of Haematolymphoid Tumours (WHO-HAEM5). Benzene, a well-known carcinogen, is widely used in industries and environmental exposures vary; however, its association with specific lymphoid neoplasm subtypes remains unclear due to historical classification challenges. This study aimed to clarify the risk of lymphoid neoplasms related to benzene exposure using the updated WHO-HAEM5 framework.<\/jats:p>\n                  <jats:p>A systematic review and meta-analysis were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible studies were comparative human studies evaluating benzene exposure and lymphoid neoplasm risk, with sufficient data for risk estimates. Inclusion criteria specified study designs, participants, exposures and outcomes based on clinical diagnoses. Data were independently extracted by multiple reviewers. The main outcome was risk of lymphoid neoplasms and subtypes analysed by random-effects meta-analysis with heterogeneity and bias assessments.<\/jats:p>\n                  <jats:p>From 1488 records, 95 studies met criteria (65 occupational and 30 environmental exposure). Benzene exposure significantly increased overall lymphoid neoplasm risk (RR 1.26; 95% CI 1.18 to 1.35). B-cell neoplasms showed elevated risk (RR 1.26; 95% CI 1.16 to 1.37), including mature B-cell neoplasms, Hodgkin lymphoma and plasma cell neoplasms. T-cell and natural killer cell neoplasm risk was not significantly increased overall. Occupational exposures conferred higher risks with lower heterogeneity than environmental exposures.<\/jats:p>\n                  <jats:p>Benzene exposure is strongly associated with increased risk of lymphoid neoplasms, particularly B-cell subtypes, supported by the refined WHO-HAEM5 classification reducing heterogeneity. This study underscores the importance of biologically informed disease classification and the need for targeted occupational safety and environmental health policies.<\/jats:p>\n                  <jats:p>\n                    The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (Registration ID:\n                    <jats:named-content content-type=\"\">CRD420251063844)<\/jats:named-content>\n                    <jats:named-content content-type=\"\">.<\/jats:named-content>\n                  <\/jats:p>","DOI":"10.1136\/oemed-2025-110652","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T17:20:50Z","timestamp":1777915250000},"page":"113-120","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Lymphoid neoplasms and benzene exposure using a revised classification scheme: systematic review and meta-analysis"],"prefix":"10.1136","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4009-1708","authenticated-orcid":false,"given":"Hyun-Wook","family":"Park","sequence":"first","affiliation":[{"name":"Department of Preventive Medicine, Chung-Ang University College of Medicine, Dongjak-gu, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4430-4100","authenticated-orcid":false,"given":"Youjin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology, Asan Medical Center, Songpa-Gu, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung-Yeon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeonjae","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Chung-Ang University College of Medicine, Dongjak-gu, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6408-7668","authenticated-orcid":false,"given":"Wanhyung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Chung-Ang University College of Medicine, Dongjak-gu, Seoul, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"2026101605202000000_83.2.113.1","doi-asserted-by":"publisher","DOI":"10.1097\/PPO.0000000000000451"},{"key":"2026101605202000000_83.2.113.2","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-022-01620-2"},{"key":"2026101605202000000_83.2.113.3","doi-asserted-by":"crossref","unstructured":"Li W . The 5(th) edition of the world health organization classification of hematolymphoid tumors . In: Li W , ed. Leukemia. Brisbane (AU), 2022.","DOI":"10.36255\/exon-publications-leukemia-who-5th-edition-hematolymphoid-tumors"},{"key":"2026101605202000000_83.2.113.4","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-022-01613-1"},{"key":"2026101605202000000_83.2.113.5","unstructured":"Agency for toxic substances and disease registry . Toxicological profile for benzene. Atlanta (GA), 2007."},{"key":"2026101605202000000_83.2.113.6","unstructured":"IARC Working Group on the Evaluation of Carcinogenic Risks to Humans . Benzene. Lyon (FR), 2018. Available: https:\/\/publications.iarc.fr\/576"},{"key":"2026101605202000000_83.2.113.7","unstructured":"World Health Organization . Preventing disease through healthy environments: exposure to benzene: a major public health concern. Geneva, 2019. Available: https:\/\/iris.who.int\/handle\/10665\/329481"},{"key":"2026101605202000000_83.2.113.8","unstructured":"IARC Working Group on the Evaluation of Carcinogenic Risks to Humans . Chemical agents and related occupations. Lyon (FR), 2012. Available: https:\/\/publications.iarc.who.int\/123"},{"key":"2026101605202000000_83.2.113.9","doi-asserted-by":"publisher","DOI":"10.1093\/carcin\/bgr297"},{"key":"2026101605202000000_83.2.113.10","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1177\/0960327119895570","article-title":"Genetic, epigenetic, and lineage-directed mechanisms in benzene-induced malignancies and hematotoxicity targeting hematopoietic stem cells niche","volume":"39","author":"Dewi","year":"2020","journal-title":"Hum Exp Toxicol"},{"key":"2026101605202000000_83.2.113.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.cbi.2009.12.021"},{"key":"2026101605202000000_83.2.113.12","unstructured":"Rothman KJ , Greenland S . Modern Epidemiology. Philadelphia, PA: Lippincott-Raven, 1998."},{"key":"2026101605202000000_83.2.113.13","doi-asserted-by":"publisher","DOI":"10.5271\/sjweh.2720"},{"key":"2026101605202000000_83.2.113.14","doi-asserted-by":"publisher","DOI":"10.1177\/003591576505800503"},{"key":"2026101605202000000_83.2.113.15","first-page":"3","article-title":"Assessing effects of confounding variables","volume":"108","author":"Schlesselman","year":"1978","journal-title":"Am J Epidemiol"},{"key":"2026101605202000000_83.2.113.16","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1002\/jrsm.12","article-title":"A basic introduction to fixed-effect and random-effects models for meta-analysis","volume":"1","author":"Borenstein","year":"2010","journal-title":"Res Synth Methods"},{"key":"2026101605202000000_83.2.113.17","doi-asserted-by":"crossref","DOI":"10.1136\/bmjos-2020-100074","article-title":"Comparison of commonly used methods in random effects meta-analysis: application to preclinical data in drug discovery research","volume":"5","author":"Tanriver-Ayder","year":"2021","journal-title":"BMJ Open Sci"},{"key":"2026101605202000000_83.2.113.18","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"2026101605202000000_83.2.113.19","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"2026101605202000000_83.2.113.20","doi-asserted-by":"crossref","first-page":"e633","DOI":"10.1016\/S2542-5196(21)00149-2","article-title":"Benzene exposure and non-Hodgkin lymphoma: a systematic review and meta-analysis of human studies","volume":"5","author":"Rana","year":"2021","journal-title":"Lancet Planet Health"},{"key":"2026101605202000000_83.2.113.21","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.shaw.2024.02.001","article-title":"Genotoxic Effects on Gas Station Attendants in South-southeastern M\u00e9xico due to Prolonged and Chronic Exposure to Gasoline","volume":"15","author":"Mart\u00ednez-Salinas","year":"2024","journal-title":"Saf Health Work"},{"key":"2026101605202000000_83.2.113.22","doi-asserted-by":"crossref","DOI":"10.3390\/ijms22094426","article-title":"The Bone Marrow Niche in B-Cell Acute Lymphoblastic Leukemia: The Role of Microenvironment from Pre-Leukemia to Overt Leukemia","volume":"22","author":"Dander","year":"2021","journal-title":"Int J Mol Sci"},{"key":"2026101605202000000_83.2.113.23","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2020-106517"},{"key":"2026101605202000000_83.2.113.24","doi-asserted-by":"publisher","DOI":"10.1016\/0041-008X(86)90390-X"},{"key":"2026101605202000000_83.2.113.25","doi-asserted-by":"crossref","first-page":"114924","DOI":"10.1016\/j.ecoenv.2023.114924","article-title":"Benzene induces spleen injury through the B cell receptor signaling pathway","volume":"257","author":"Qiao","year":"2023","journal-title":"Ecotoxicol Environ Saf"},{"key":"2026101605202000000_83.2.113.26","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.cbi.2005.03.015","article-title":"Lymphocyte toxicity and T cell receptor excision circles in workers exposed to benzene","volume":"153\u2013154","author":"Lan","year":"2005","journal-title":"Chem Biol Interact"},{"key":"2026101605202000000_83.2.113.27","doi-asserted-by":"publisher","DOI":"10.1007\/s004200000126"},{"key":"2026101605202000000_83.2.113.28","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2004-01-0037"},{"key":"2026101605202000000_83.2.113.29","doi-asserted-by":"publisher","DOI":"10.1006\/scbi.2001.0423"},{"key":"2026101605202000000_83.2.113.30","first-page":"1023","article-title":"Benzene and its phenolic metabolites produce oxidative DNA damage in HL60 cells in vitro and in the bone marrow in vivo","volume":"53","author":"Kolachana","year":"1993","journal-title":"Cancer Res"},{"key":"2026101605202000000_83.2.113.31","doi-asserted-by":"crossref","DOI":"10.1289\/EHP15086","article-title":"Occupational Benzene Exposure and Lung Cancer in Human Studies: A Systematic Review and Meta-Analysis","volume":"132","author":"Wan","year":"2024","journal-title":"Environ Health Perspect"},{"key":"2026101605202000000_83.2.113.32","doi-asserted-by":"crossref","DOI":"10.35371\/aoem.2024.36.e20","article-title":"Relationship between the use of hair products and urine benzophenone-3: the Korean National Environmental Health Survey (KoNEHS) cycle 4","volume":"36","author":"Kim","year":"2024","journal-title":"Ann Occup Environ Med"}],"container-title":["Occupational and Environmental Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/oemed-2025-110652","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:20:42Z","timestamp":1792153242000},"score":1,"resource":{"primary":{"URL":"https:\/\/oem.bmj.com\/lookup\/doi\/10.1136\/oemed-2025-110652"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":32,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,5,21]]},"published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1136\/oemed-2025-110652"],"URL":"https:\/\/doi.org\/10.1136\/oemed-2025-110652","relation":{},"ISSN":["1351-0711","1470-7926"],"issn-type":[{"value":"1351-0711","type":"print"},{"value":"1470-7926","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]}}}