Exposure to benzene and childhood leukaemia

A pilot case-control study

Susanna Lagorio, Daniela Ferrante, Alessandra Ranucci, Sara Negri, Paolo Sacco, Roberto Rondelli, Santina Cannizzaro, Maria Valeria Torregrossa, Pierluigi Cocco, Francesco Forastiere, Lucia Miligi, Luigi Bisanti, Corrado Magnani

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objectives: Main purpose To evaluate the feasibility of a measurement-based assessment of benzene exposure in case-control studies of paediatric cancer; Additional aims To identify the sources of exposure variability; to assess the performance of two benzene biomarkers; to verify the occurrence of participation bias; to check whether exposures to benzene and to 50 Hz magnetic fields were correlated, and might exert reciprocal confounding effects. Design: Pilot case-control study of childhood leukaemia and exposure to benzene assessed by repeated seasonal weekly measurements in breathing zone air samples and outside the children's dwellings, with concurrent determinations of cotinine, t-t-muconic acid (MA) and sulfo-phenylmercapturic acid (S-PMA) in urine. Participants: 108 cases and 194 controls were eligible for inclusion. Results: Full-participation was obtained from 46 cases and 60 controls, with low dropout rates before four repeats (11% and 17%); an additional 23 cases and 80 controls allowed the collection of outdoor air samples only. The average benzene concentration in personal and outdoor air samples was 3 μg/m3 (SD 1.45) and 2.7 μg/m3 (SD 1.41), respectively. Personal exposure was strongly influenced by outdoor benzene concentrations, higher in the cold seasons than in warm seasons, and not affected by gender, age, area of residence or caseness. Urinary excretion of S-PMA and personal benzene exposure were well correlated. Outdoor benzene levels were lower among participant controls compared with non-participants, but did not differ between participant and non-participant cases; the direction of the bias was found to depend on the cut-point chosen to distinguish exposed and unexposed. Exposures to benzene and extremely lowfrequency magnetic fields were positively correlated. Conclusions: Repeated individual measurements are needed to account for the seasonal variability in benzene exposure, and they have the additional advantage of increasing the study power. Measurement-based assessment of benzene exposure in studies of childhood leukaemia appears feasible, although it is financially and logistically demanding.

Original languageEnglish
Article number002275
JournalBMJ Open
Volume3
Issue number2
DOIs
Publication statusPublished - 2013

Fingerprint

Benzene
Case-Control Studies
Leukemia
Air
Magnetic Fields
Cotinine
Respiration
Biomarkers
Urine
Pediatrics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Lagorio, S., Ferrante, D., Ranucci, A., Negri, S., Sacco, P., Rondelli, R., ... Magnani, C. (2013). Exposure to benzene and childhood leukaemia: A pilot case-control study. BMJ Open, 3(2), [002275]. https://doi.org/10.1136/bmjopen-2012-002275

Exposure to benzene and childhood leukaemia : A pilot case-control study. / Lagorio, Susanna; Ferrante, Daniela; Ranucci, Alessandra; Negri, Sara; Sacco, Paolo; Rondelli, Roberto; Cannizzaro, Santina; Torregrossa, Maria Valeria; Cocco, Pierluigi; Forastiere, Francesco; Miligi, Lucia; Bisanti, Luigi; Magnani, Corrado.

In: BMJ Open, Vol. 3, No. 2, 002275, 2013.

Research output: Contribution to journalArticle

Lagorio, S, Ferrante, D, Ranucci, A, Negri, S, Sacco, P, Rondelli, R, Cannizzaro, S, Torregrossa, MV, Cocco, P, Forastiere, F, Miligi, L, Bisanti, L & Magnani, C 2013, 'Exposure to benzene and childhood leukaemia: A pilot case-control study', BMJ Open, vol. 3, no. 2, 002275. https://doi.org/10.1136/bmjopen-2012-002275
Lagorio, Susanna ; Ferrante, Daniela ; Ranucci, Alessandra ; Negri, Sara ; Sacco, Paolo ; Rondelli, Roberto ; Cannizzaro, Santina ; Torregrossa, Maria Valeria ; Cocco, Pierluigi ; Forastiere, Francesco ; Miligi, Lucia ; Bisanti, Luigi ; Magnani, Corrado. / Exposure to benzene and childhood leukaemia : A pilot case-control study. In: BMJ Open. 2013 ; Vol. 3, No. 2.
@article{725cd14d7eaa441195f76f15d83e06e4,
title = "Exposure to benzene and childhood leukaemia: A pilot case-control study",
abstract = "Objectives: Main purpose To evaluate the feasibility of a measurement-based assessment of benzene exposure in case-control studies of paediatric cancer; Additional aims To identify the sources of exposure variability; to assess the performance of two benzene biomarkers; to verify the occurrence of participation bias; to check whether exposures to benzene and to 50 Hz magnetic fields were correlated, and might exert reciprocal confounding effects. Design: Pilot case-control study of childhood leukaemia and exposure to benzene assessed by repeated seasonal weekly measurements in breathing zone air samples and outside the children's dwellings, with concurrent determinations of cotinine, t-t-muconic acid (MA) and sulfo-phenylmercapturic acid (S-PMA) in urine. Participants: 108 cases and 194 controls were eligible for inclusion. Results: Full-participation was obtained from 46 cases and 60 controls, with low dropout rates before four repeats (11{\%} and 17{\%}); an additional 23 cases and 80 controls allowed the collection of outdoor air samples only. The average benzene concentration in personal and outdoor air samples was 3 μg/m3 (SD 1.45) and 2.7 μg/m3 (SD 1.41), respectively. Personal exposure was strongly influenced by outdoor benzene concentrations, higher in the cold seasons than in warm seasons, and not affected by gender, age, area of residence or caseness. Urinary excretion of S-PMA and personal benzene exposure were well correlated. Outdoor benzene levels were lower among participant controls compared with non-participants, but did not differ between participant and non-participant cases; the direction of the bias was found to depend on the cut-point chosen to distinguish exposed and unexposed. Exposures to benzene and extremely lowfrequency magnetic fields were positively correlated. Conclusions: Repeated individual measurements are needed to account for the seasonal variability in benzene exposure, and they have the additional advantage of increasing the study power. Measurement-based assessment of benzene exposure in studies of childhood leukaemia appears feasible, although it is financially and logistically demanding.",
author = "Susanna Lagorio and Daniela Ferrante and Alessandra Ranucci and Sara Negri and Paolo Sacco and Roberto Rondelli and Santina Cannizzaro and Torregrossa, {Maria Valeria} and Pierluigi Cocco and Francesco Forastiere and Lucia Miligi and Luigi Bisanti and Corrado Magnani",
year = "2013",
doi = "10.1136/bmjopen-2012-002275",
language = "English",
volume = "3",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "2",

}

TY - JOUR

T1 - Exposure to benzene and childhood leukaemia

T2 - A pilot case-control study

AU - Lagorio, Susanna

AU - Ferrante, Daniela

AU - Ranucci, Alessandra

AU - Negri, Sara

AU - Sacco, Paolo

AU - Rondelli, Roberto

AU - Cannizzaro, Santina

AU - Torregrossa, Maria Valeria

AU - Cocco, Pierluigi

AU - Forastiere, Francesco

AU - Miligi, Lucia

AU - Bisanti, Luigi

AU - Magnani, Corrado

PY - 2013

Y1 - 2013

N2 - Objectives: Main purpose To evaluate the feasibility of a measurement-based assessment of benzene exposure in case-control studies of paediatric cancer; Additional aims To identify the sources of exposure variability; to assess the performance of two benzene biomarkers; to verify the occurrence of participation bias; to check whether exposures to benzene and to 50 Hz magnetic fields were correlated, and might exert reciprocal confounding effects. Design: Pilot case-control study of childhood leukaemia and exposure to benzene assessed by repeated seasonal weekly measurements in breathing zone air samples and outside the children's dwellings, with concurrent determinations of cotinine, t-t-muconic acid (MA) and sulfo-phenylmercapturic acid (S-PMA) in urine. Participants: 108 cases and 194 controls were eligible for inclusion. Results: Full-participation was obtained from 46 cases and 60 controls, with low dropout rates before four repeats (11% and 17%); an additional 23 cases and 80 controls allowed the collection of outdoor air samples only. The average benzene concentration in personal and outdoor air samples was 3 μg/m3 (SD 1.45) and 2.7 μg/m3 (SD 1.41), respectively. Personal exposure was strongly influenced by outdoor benzene concentrations, higher in the cold seasons than in warm seasons, and not affected by gender, age, area of residence or caseness. Urinary excretion of S-PMA and personal benzene exposure were well correlated. Outdoor benzene levels were lower among participant controls compared with non-participants, but did not differ between participant and non-participant cases; the direction of the bias was found to depend on the cut-point chosen to distinguish exposed and unexposed. Exposures to benzene and extremely lowfrequency magnetic fields were positively correlated. Conclusions: Repeated individual measurements are needed to account for the seasonal variability in benzene exposure, and they have the additional advantage of increasing the study power. Measurement-based assessment of benzene exposure in studies of childhood leukaemia appears feasible, although it is financially and logistically demanding.

AB - Objectives: Main purpose To evaluate the feasibility of a measurement-based assessment of benzene exposure in case-control studies of paediatric cancer; Additional aims To identify the sources of exposure variability; to assess the performance of two benzene biomarkers; to verify the occurrence of participation bias; to check whether exposures to benzene and to 50 Hz magnetic fields were correlated, and might exert reciprocal confounding effects. Design: Pilot case-control study of childhood leukaemia and exposure to benzene assessed by repeated seasonal weekly measurements in breathing zone air samples and outside the children's dwellings, with concurrent determinations of cotinine, t-t-muconic acid (MA) and sulfo-phenylmercapturic acid (S-PMA) in urine. Participants: 108 cases and 194 controls were eligible for inclusion. Results: Full-participation was obtained from 46 cases and 60 controls, with low dropout rates before four repeats (11% and 17%); an additional 23 cases and 80 controls allowed the collection of outdoor air samples only. The average benzene concentration in personal and outdoor air samples was 3 μg/m3 (SD 1.45) and 2.7 μg/m3 (SD 1.41), respectively. Personal exposure was strongly influenced by outdoor benzene concentrations, higher in the cold seasons than in warm seasons, and not affected by gender, age, area of residence or caseness. Urinary excretion of S-PMA and personal benzene exposure were well correlated. Outdoor benzene levels were lower among participant controls compared with non-participants, but did not differ between participant and non-participant cases; the direction of the bias was found to depend on the cut-point chosen to distinguish exposed and unexposed. Exposures to benzene and extremely lowfrequency magnetic fields were positively correlated. Conclusions: Repeated individual measurements are needed to account for the seasonal variability in benzene exposure, and they have the additional advantage of increasing the study power. Measurement-based assessment of benzene exposure in studies of childhood leukaemia appears feasible, although it is financially and logistically demanding.

UR - http://www.scopus.com/inward/record.url?scp=84875025101&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84875025101&partnerID=8YFLogxK

U2 - 10.1136/bmjopen-2012-002275

DO - 10.1136/bmjopen-2012-002275

M3 - Article

VL - 3

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 2

M1 - 002275

ER -