National Industrial Chemicals Notification and
                Assessment Scheme




Benzene
________________________________________

Priority Existing Chemical
Assessment Report No. 21




     September 2001

 Commonwealth of Australia 2001

ISBN 0 642-51896-3


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(Cwlth), no part may be reproduced by any process without written permission from
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the Manager, Legislative Services, AusInfo, GPO Box 84, Canberra ACT 2601.




                                                            Priority Existing Chemical Number 21
                                           ii

                                          Preface

This assessment was carried out under the National Industrial Chemicals Notification and
Assessment Scheme (NICNAS). This Scheme was established by the Industrial Chemicals
(Notification and Assessment) Act 1989 (the Act), which came into operation on 17 July
1990.
The principal aim of NICNAS is to aid in the protection of people at work, the public and
the environment from the harmful effects of industrial chemicals.
NICNAS assessments are carried out in conjunction with Environment Australia (EA) and
the Therapeutic Goods Administration (TGA), which carry out the environmental and
public health assessments, respectively.
NICNAS has two major programs: the assessment of the health and environmental effects
of new industrial chemicals prior to importation or manufacture; and the other focussing on
the assessment of chemicals already in use in Australia in response to specific concerns
about their health/or environmental effects.
There is an established mechanism within NICNAS for prioritising and assessing the many
thousands of existing chemicals in use in Australia. Chemicals selected for assessment are
referred to as Priority Existing Chemicals.
This Priority Existing Chemical report has been prepared by the Director (Chemicals
Notification and Assessment) in accordance with the Act. Under the Act manufacturers and
importers of Priority Existing Chemicals are required to apply for assessment. Applicants
for assessment are given a draft copy of the report and 28 days to advise the Director of any
errors. Following the correction of any errors, the Director provides applicants and other
interested parties with a copy of the draft assessment report for consideration. This is a
period of public comment lasting for 28 days during which requests for variation of the
report may be made. Where variations are requested the Director's decision concerning
each request is made available to each respondent and to other interested parties (for a
further period of 28 days). Notices in relation to public comment and decisions made
appear in the Commonwealth Chemical Gazette.
In accordance with the Act, publication of this report revokes the declaration of this
chemical as a Priority Existing Chemical, therefore manufacturers and importers wishing to
introduce this chemical in the future need not apply for assessment. However,
manufacturers and importers need to be aware of their duty to provide any new information
to NICNAS, as required under section 64 of the Act.
Copies of this and other Priority Existing Chemical reports are available from NICNAS
either by using the prescribed application form at the back of this report, the website
www.nicnas.gov.au or ordering directly from the following address:
          GPO Box 58
          Sydney
          NSW 2001
          AUSTRALIA




Benzene                                      iii

     Priority Existing Chemical Number 21
iv

                                   Overview

Benzene (CAS No. 71-43-2) was declared a Priority Existing Chemical on 7 April 1998 in
response to occupational and public health concerns.
Benzene occurs naturally in fossil fuels and is produced incidentally in the course of natural
processes and human activities that involve the combustion of organic matter such as wood,
coal and petroleum products. The main industrial use of benzene is as a starting material for
the synthesis of other chemicals. Most benzene feedstock is imported, but some is
manufactured at an Australian steelworks as a by-product of coal coking. Large quantities
of benzene are produced during the refining of petroleum and retained as a component of
petrol. Petrol vehicle emissions are the predominant source of benzene in the environment.
Benzene is volatile and water-soluble and is considered biodegradable. Its major release is
to the atmosphere, where it will break down in a matter of weeks. Direct release to the
aquatic compartment is expected to be minor and significant removal will occur from
volatilisation. Benzene release to soil is likely to be marginal. Concentrations in aquatic
systems are expected to be far lower than of concern and a low aquatic risk is predicted.
Due to the low expected exposure, a low environmental risk to terrestrial organisms is
predicted. The short atmospheric lifetime of benzene indicates concentrations will not occur
at levels harmful to the atmosphere. While widespread transport within the troposphere is
possible, the chemical is not expected to reach the stratosphere and therefore would not
have an influence on global warming or ozone depletion.
In animals and humans, benzene is absorbed by all routes of exposure, although dermal
absorption is limited by its rapid evaporation from the skin. It is metabolised in the liver
and several other organs, including the bone marrow. The parent molecule is eliminated
with exhaled air. The metabolites are excreted in the urine.
In animals, benzene is not highly acutely toxic. Chronic exposure can result in central
nervous system depression, immunosuppression, bone marrow depression, degenerative
lesions of the gonads, foetal growth retardation, damage to genetic material and solid
tumours in several organs.
In humans, acute exposure to high concentrations of benzene vapours can result in irritation
of the skin, eyes and respiratory system and in central nervous system depression. Chronic
exposure can result in bone marrow depression and leukaemia, particularly acute myeloid
leukaemia, and possibly an increased risk of non-Hodgkin's lymphoma and multiple
myeloma. Structural and numerical chromosome aberrations have been detected in
peripheral blood cells of workers exposed to high levels of benzene. For bone marrow
depression, the lowest observed adverse effect level in humans is 7.6 parts per million
(ppm), based on minimal blood count changes in otherwise healthy workers. No threshold
has been established for the genotoxic and carcinogenic effects of benzene.
Epidemiological evidence indicates that the risk of leukaemia increases with exposure and
is significantly elevated at cumulative exposures above 50 ppm-years, corresponding to an
8-hour time-weighted average exposure above 1.25 ppm over a working life of 40 years.
Chronic benzene toxicity has been attributed to the formation of reactive metabolites that
appear to exert their toxic effect in combination, with no one metabolite accounting for all
of the observed effects.



Benzene                                       v

Benzene is currently listed in the NOHSC List of Designated Hazardous Substances with
the following classification: `Flammable', `Carcinogen, Category 1' and `Toxic: Danger of
serious damage to health by prolonged exposure through inhalation, in contact with skin
and if swallowed'. Category 1 carcinogens are those substances known to be carcinogenic
to humans. Based on the assessment of health effects, this report has concluded that
benzene also meets the NOHSC Approved Criteria for Classifying Hazardous Substances
for classification as a skin, eye and respiratory system irritant and as a mutagenic substance
in Category 3.
The public is exposed to benzene through the inhalation of indoor, in-vehicle and outdoor
air contaminated with the chemical through releases that predominantly derive from vehicle
exhaust, petrol evaporation and tobacco smoke. The 24-hour average lifetime exposure in
the Australian urban population is estimated at 5.2 parts per billion (ppb). It is one-fifth
higher in passive smokers exposed to tobacco smoke at home, at work and in their cars (6.1
ppb) and almost three times as high (15.2 ppb) in the average smoker.
Benzene-induced bone marrow depression is not expected to present a significant public
health risk. Based upon low-dose extrapolation of relevant quantitative risk estimates and
the above-mentioned exposure estimate, the excess lifetime risk of benzene-induced
leukaemia in the Australian urban population is estimated to be in the order of one case per
10,000 with increased risk in sensitive subpopulations or at higher exposure levels.
However, the estimated excess risk is based on substantial uncertainties in the exposure
assessment which should be validated through collection of monitoring data.
As benzene is an established human carcinogen for which no safe level of exposure has
been established, it is recommended that any increase in public exposure be avoided and
that measures be taken to reduce exposure where this is practicable. The establishment of a
national ambient air benzene level would facilitate these objectives.
Occupational exposure to benzene is predominantly by the inhalation route. It occurs
primarily in the petroleum, steel, chemical and associated industries and in laboratories
using the chemical for research or analysis. Occupational exposure to benzene can also
result from the contamination of workplace environments with petrol vapours, engine
exhaust or tobacco smoke, for example, in vehicle mechanics, professional drivers and
hospitality workers. It is estimated that current long-term occupational exposures to
benzene are less than or equal to 0.7 ppm in the steel and associated industries and during
maintenance of phenol plants; less than 0.1 ppm in the upstream petroleum industry (oil
and gas production); less than 0.5 ppm in the chemical industry and in laboratory workers;
less than 0.2 ppm in vehicle mechanics; less than 0.7 ppm in the downstream petroleum
industry (refining, distribution and marketing of petroleum products); and less than 0.05
ppm in people who work in roadside or in-vehicle environments contaminated with vehicle
exhaust or in indoor environments contaminated with tobacco smoke.
The occupational risk characterisation found no cause for concern about acute health effects
or bone marrow depression, given the control measures which are already in place in
Australian workplaces. However, there is cause for concern about the risk for leukaemia in
all workers with repeated occupational exposure to benzene. There is no known threshold
for the carcinogenic effects of benzene, but because the risk for leukaemia increases with
exposure, it can be reduced by controlling exposure to the highest practicable standard.
With regard to occupational health and safety, it is recommended that the national exposure
standard for benzene be revised. It is recommended that an eight-hour time-weighted
average of 0.5 ppm be adopted. It is further recommended that the current hazard
classification be amended to include classification as `Irritating to eyes, respiratory system
and skin' (risk phrase R36/37/38) and as a mutagenic substance in Category 3 (risk phrase

                                                                Priority Existing Chemical Number 21
                                              vi

R40: `Possible risks of irreversible effects, Mutagen Category 3'). Occupational exposures
to benzene should be minimised by improving workplace control measures and by using
the best available technology.
This report has identified the need to reduce public exposure to air benzene levels as much
as practicable. Public health recommendations include measures to reduce indoor benzene
levels, such as proper sealing of attached garages and minimising environmental tobacco
smoke. In order to better characterise the risk to the public from benzene exposure, personal
and ambient air monitoring is recommended and a national ambient air standard should be
set.




Benzene                                      vii

       Priority Existing Chemical Number 21
viii

                                       Contents

PREFACE                                                                  iii


OVERVIEW                                                                 iv


ABBREVIATIONS AND ACRONYMS                                               xv


          INTRODUCTION                                                    1
1.
          1.1    Declaration                                              1
          1.2    Objectives                                               1
          1.3    Sources of information                                   1
          1.4    Peer review                                              2


2.        BACKGROUND                                                      3
          2.1    Introduction                                             3
          2.2    International perspective                                3
          2.3    Australian perspective                                   3
          2.4    Assessments by other national or international bodies    5


3.        APPLICANTS                                                      6


4.        CHEMICAL IDENTITY AND COMPOSITION                               7
          4.1    Chemical name (IUPAC)                                    7
          4.2    Registry numbers                                         7
          4.3    Other names                                              7
          4.4    Molecular formula                                        7
          4.5    Structural formula                                       7
          4.6    Molecular weight                                         8
          4.7    Composition of commercial grade product                  8


5.        PHYSICAL AND CHEMICAL PROPERTIES                                9
          5.1    Physical state                                           9
          5.2    Physical properties                                      9
          5.3    Chemical properties                                      9


6.        METHODS OF DETECTION AND ANALYSIS                              11
          6.1    Characterisation                                        11
          6.2    Detection and analysis                                  11
          6.3    Atmospheric monitoring methods                          11

Benzene                                         ix

     6.4    Biological monitoring methods                                                       13


7.   MANUFACTURE, IMPORTATION AND USE                                                          14
     7.1    Manufacture and importation                                                         14
     7.2    Manufacturing processes and end use                                                 15
            7.2.1     Petroleum industry                                                        15
            7.2.2     Steel and associated industries                                           19
            7.2.3     Chemical industry                                                         20
            7.2.4     Laboratory uses                                                           22
            7.2.5     Coincidental production                                                   23
     7.3    Summary                                                                             23


8.   ENVIRONMENTAL RELEASE, FATE AND EFFECTS                                                   24
     8.1    Environmental release                                                               24
     8.2    Environmental fate                                                                  24
            8.2.1     Atmospheric fate                                                          24
            8.2.2     Aquatic fate                                                              27
            8.2.3     Terrestrial fate                                                          28
            8.2.4     Biodegradation                                                            29
            8.2.5     Bioaccumulation                                                           30
     8.3    Effects on organisms in the environment                                             31
            8.3.1     Aquatic organisms                                                         31
            8.3.2     Terrestrial organisms                                                     33
     8.4    Summary                                                                             34


9.   KINETICS AND METABOLISM                                                                   35
     9.1    Absorption                                                                          35
            9.1.1     Animal studies                                                            35
            9.1.2     Human studies                                                             36
     9.2    Distribution                                                                        38
            9.2.1     Animal studies                                                            38
            9.2.2     Human studies                                                             39
     9.3    Metabolism                                                                          40
            9.3.1     General metabolic pathways                                                40
            9.3.2     Formation of phenolic metabolites                                         42
            9.3.3     Formation of trans,trans-muconaldehyde                                    43
     9.4    Elimination and excretion                                                           44
            9.4.1     Animal data                                                               44
            9.4.2     Human data                                                                46
     9.5    Comparative kinetics and metabolism                                                 47
            9.5.1     Oral studies                                                              47


                                                               Priority Existing Chemical Number 21
                                              x

                 9.5.2        Inhalation studies                        48
                 9.5.3        Dermal studies                            49
                 9.5.4        In vitro studies                          49
          9.6    Summary                                                50


10.       EFFECTS ON LABORATORY MAMMALS AND OTHER TEST SYSTEMS          51
          10.1   Acute toxicity                                         51
          10.2   Irritation and corrosivity                             52
          10.3   Sensitisation                                          52
          10.4   Repeated dose toxicity (other than carcinogenicity)    52
                 10.4.1       Short-term exposure                       52
                 10.4.2       Long-term exposure                        55
          10.5   Reproductive toxicity                                  56
                 10.5.1       Effects on fertility and lactation        56
                 10.5.2       Developmental toxicity                    58
          10.6   Genotoxicity                                           63
          10.7   Carcinogenicity                                        64
          10.8   Summary and conclusions                                69


11.       HUMAN HEALTH EFFECTS                                          71
          11.1   Acute toxicity                                         71
          11.2   Irritation                                             72
          11.3   Sensitisation                                          72
          11.4   Repeated dose toxicity (other than carcinogenicity)    72
                 11.4.1       Neurological effects                      72
                 11.4.2       Effects on the immune system              72
                 11.4.3       Cardiovascular effects                    73
                 11.4.4       Haematological effects                    73
                 11.4.5       Reproductive effects                      78
                 11.4.6       Other health effects                      81
          11.5   Genotoxic effects                                      81
          11.6   Carcinogenicity                                        83
                 11.6.1       Cohort studies                            83
                 11.6.2       Case-control studies                      96
                 11.6.3       Ecological studies                       101
          11.7   The Illawarra leukaemia cluster                       102
          11.8   Summary and conclusions                               102


12.       MODES OF ACTION                                              104
          12.1   Activation of benzene metabolites                     104
                 12.1.1       Activation of phenol                     105


Benzene                                              xi

             12.1.2     Activation of hydroquinone and catechol                                     105
             12.1.3     Role of cyclooxygenase                                                      106
             12.1.4     Formation of reactive oxygen species                                        106
      12.2   Reactivity of benzene metabolites                                                      108
             12.2.1     Genotoxicity                                                                108
             12.2.2     Oxidative stress                                                            110
             12.2.3     Modulation of cellular function                                             111
      12.3   Critical biological effects                                                            112
             12.3.1     Bone marrow toxicity                                                        112
             12.3.2     Leukaemia                                                                   112
             12.3.3     Tumours in Zymbal, Harderian, lacrimal and mammary
                        glands                                                                      113
      12.4   Interindividual variations in susceptibility                                           114
             12.4.1     Gender effects                                                              114
             12.4.2     Genetic polymorphisms                                                       115
             12.4.3     Environmental influences                                                    117
      12.5   Summary                                                                                118


13.   HEALTH HAZARD ASSESSMENT                                                                      120
      13.1   Acute effects                                                                          120
             13.1.1     CNS effects                                                                 120
             13.1.2     Skin, eye and respiratory tract irritation                                  120
      13.2   Repeated dose effects (other than carcinogenicity)                                     120
             13.2.1     CNS effects                                                                 120
             13.2.2     Immunosuppression                                                           121
             13.2.3     Bone marrow depression                                                      121
             13.2.4     Fertility effects                                                           122
             13.2.5     Developmental effects                                                       123
             13.2.6     Other non-neoplastic effects                                                123
      13.3   Genotoxicity                                                                           123
      13.4   Carcinogenicity                                                                        124
             13.4.1     Leukaemia                                                                   124
             13.4.2     Solid tumours                                                               125
      13.5   Summary and conclusions                                                                126


14.   CLASSIFICATION FOR OCCUPATIONAL HEALTH AND SAFETY                                             128
      14.1   Physicochemical hazards                                                                128
      14.2   Health hazards                                                                         128
             14.2.1     Acute toxicity                                                              128
             14.2.2     Irritant and corrosive effects                                              129
             14.2.3     Sensitising effects                                                         129


                                                                     Priority Existing Chemical Number 21
                                              xii

                 14.2.4     Effects from repeated or prolonged exposure          129
                 14.2.5     Reproductive effects                                 130
                 14.2.6     Mutagenic effects                                    131
                 14.2.7     Carcinogenicity                                      132
          14.3   Summary                                                         132


15.       ENVIRONMENTAL EXPOSURE                                                 133
          15.1   Point source releases to air                                    133
                 15.1.1     Petroleum industry                                   133
                 15.1.2     Steel and associated industries                      136
                 15.1.3     Aluminium industry                                   137
                 15.1.4     Chemical industry                                    139
                 15.1.5     Fossil fuel burning for power generation             141
                 15.1.6     Other point sources                                  142
                 15.1.7     Summary                                              143
          15.2   Diffuse releases to urban air                                   144
                 15.2.1     Emissions estimation                                 144
                 15.2.2     Predicted environmental concentration in urban air   147
          15.3   Indoor air concentrations                                       149
                 15.3.1     Homes                                                149
                 15.3.2     Non-residential buildings                            152
                 15.3.3     Motor vehicles and other means of transportation     153
          15.4   Concentrations in water and soil                                154
                 15.4.1     Water                                                154
                 15.4.2     Soil                                                 156
          15.5   Summary                                                         156


16.       PUBLIC EXPOSURE                                                        157
          16.1   Direct exposure                                                 157
          16.2   Indirect exposure via the environment                           157
          16.3   Exposure assessment                                             159
          16.4   Summary and conclusions                                         162


17.       OCCUPATIONAL EXPOSURE                                                  164
          17.1   Petroleum industry                                              164
                 17.1.1     Petroleum production and refining                    164
                 17.1.2     Petrol distribution and marketing                    166
                 17.1.3     Petroleum and petrol cleaning operations             168
                 17.1.4     Conclusions                                          168
          17.2   Steel and coal tar distillation industries                      168
                 17.2.1     Coke ovens                                           168


Benzene                                            xiii

             17.2.2    Coal gas by-product plants                                               169
             17.2.3    Coal tar distillation                                                    169
             17.2.4    Conclusions                                                              170
      17.3   Chemical industry                                                                  170
             17.3.1    Ethane and naphtha (gas oil) cracking                                    170
             17.3.2    Bulk distribution                                                        171
             17.3.3    Butadiene rubber manufacture                                             172
             17.3.4    Styrene and phenol manufacture                                           172
             17.3.5    Conclusions                                                              173
      17.4   Laboratory use for research or analysis                                            174
      17.5   Contaminated workplace environments                                                174
             17.5.1    Petrol vapours and vehicle exhaust                                       174
             17.5.2    Environmental tobacco smoke                                              175
             17.5.3    Conclusions                                                              176
      17.6   Aluminium industry                                                                 176
      17.7   Summary                                                                            177


18.   RISK CHARACTERISATION                                                                     178
      18.1   Environmental risks                                                                178
             18.1.1    Atmospheric risk                                                         178
             18.1.2    Aquatic risk                                                             179
             18.1.3    Terrestrial risk                                                         179
      18.2   Occupational health risks                                                          180
             18.2.1    Acute effects                                                            180
             18.2.2    Effects from repeated exposure                                           180
             18.2.3    Uncertainties involved                                                   183
             18.2.4    Areas of concern                                                         184
      18.3   Public health risks                                                                184
             18.3.1    Bone marrow depression                                                   184
             18.3.2    Leukaemia                                                                185
             18.3.3    Uncertainties involved                                                   186
             18.3.4    Conclusions                                                              186
      18.4   Risk assessments by other national or international bodies                         187


19.   RISK MANAGEMENT                                                                           190
      19.1   Environmental and public health controls                                           190
      19.2   Occupational health and safety controls                                            191
             19.2.1    Regulatory controls                                                      191
             19.2.2    Current control measures                                                 195
      19.3   National transport regulation (ADG Code)                                           198



                                                                 Priority Existing Chemical Number 21
                                               xiv

20.       DISCUSSION AND CONCLUSIONS                      199
          20.1   Environmental exposure and risks         199
          20.2   Health effects                           199
          20.3   Public exposure and health risks         201
          20.4   Occupational exposure and health risks   202
          20.5   Data gaps                                205


21.       RECOMMENDATIONS                                 206


22.       SECONDARY NOTIFICATION                          210


APPENDIX 1                                                211


REFERENCES                                                218




Benzene                                         xv

         Abbreviations and Acronyms

          American Conference of Governmental Industrial Hygienists
ACGIH
          Australian Dangerous Goods
ADG
          Australian Institute of Petroleum
AIP
          absolute lymphocyte count
ALC
          acute lymphatic leukaemia
ALL
          acute myeloid leukaemia
AML
          acute non-lymphocytic leukaemia
ANLL
          atmosphere
atm
          light aircraft gasoline
Avgas
          bioconcentration factor
BCF
          benzene poisoning
BP
          benzene/toluene/xylenes
BTX
          body weight
BW
          centigrade
C
          Chemical Abstracts Service
CAS
          colony forming units of erythrocyte progenitor cells
CFU-E
          colony forming units of granulocyte/macrophage progenitor cells
CFU-M
          confidence interval
CI
          chronic lymphatic leukaemia
CLL
          centimetre
cm
cm2       square centimetre
cm3       cubic centimetre
          Chemical Manufacturers Association
CMA
          chronic myeloid leukaemia
CML
          central nervous system
CNS
          colony stimulating factor
CSF
          cytochrome-P450
CYP
          deoxyribonucleic acid
DNA
          Environment Australia
EA
          median effective concentration
EC50
          European Inventory of Existing Chemical Substances
EINECS
          Environment Protection Authority
EPA
          environmental tobacco smoke
ETS
          gram
g
          gas chromatography
GC
          gas chromatography-mass spectrometry
GC-MS
          gestation day
GD
          Good Laboratory Practices
GLP
          granulocyte/macrophage colony stimulating factor
GM-CSF
          glutathione
GSH
          glutathione-S-transferase
GST
          hour
h
          hectare
ha
          haemoglobin
Hb
          haematocrit
Hct

                                                      Priority Existing Chemical Number 21
                                    xvi

          International Agency for Research on Cancer
IARC
          interleukin-1
IL-1
          International Programme on Chemical Safety
IPCS
          International Uniform Chemical Information Database
IUCLID
          International Union for Pure and Applied Chemistry
IUPAC
          Kelvin
K
          kilogram
kg
          Michaelis-Menten constant
Km
          kilometre
km
km2       square kilometre
          sorption coefficient
Koc
          kilopascal
kPa
          kilotonne
kt
          litre
L
          lymphocyte
LC
          median lethal concentration
LC50
          median lethal dose
LD50
          lowest observed adverse effect level
LOAEL
          leaded petrol
LP
          liquid pressurised gas
LPG
m3        cubic meter
          mean corpuscular volume
MCV
          myelodysplastic syndrome
MDS
          milligram
mg
          millilitre
mL
          megalitre
ML
          millimolar
mM
          multiple myeloma
MM
          micronucleus
MN
          mole
mol
          material safety data sheet
MSDS
          nicotinamide adenine dinucleotide phosphate
NADPH
          National Environment Protection Council
NEPC
          National Environment Protection Measures
NEPM
          nanogram
ng
          National Health Interview Survey
NHIS
          non-Hodgkin's lymphoma
NHL
          National Industrial Chemicals Notification and Assessment Scheme
NICNAS
          National Institute of Occupational Safety and Health
NIOSH
          nanometre
nm
          nanomole
nmol
          nanomolar
nM
          no observed adverse effect level
NOAEL
          no observed effect concentration
NOEC
          National Occupational Health and Safety Commission
NOHSC
          National Pollutant Inventory
NPI
          NAD(P)H:quinone oxidoreductase
NQO1
          non-steroidal anti-inflammatory drug
NSAID
          Organisation for Economic Co-Operation and Development
OECD
          odds ratio
OR

Benzene                            xvii

             Occupational Safety and Health Administration
OSHA
             polycyclic aromatic hydrocarbon
PAH
             prostaglandin E2
PGE2
             protein kinase C
PKC
             blood platelet
Plt
             predicted no-effect concentration
PNEC
             octanol/water partition coefficient
Po/w
             persistent organic pollutant
POP
             parts per billion
ppb
             personal protective equipment
PPE
             parts per million
ppm
             premium unleaded petrol
PULP
             red blood cell (erythrocyte)
RBC
             ribonucleic acid
RNA
             relative risk
RR
             second
s
             spontaneous abortion
SAb
             secondary acute myeloid leukaemia
s-AML
             subcutaneous
SC
             sister chromatid exchange
SCE
             small-for-gestational age
SGA
             standardised incidence rate
SIR
             State marketing area
SMA
             standardised mortality rate
SMR
             sewage treatment plant
STP
             Standard for the Uniform Scheduling of Drugs and Poisons
SUSDP
             tonne
t
             Technical Guidance Document
TGD
             time-weighted average
TWA
             8-h time-weighted average
TWA8
             unleaded petrol
ULP
             United Nations
UN
             United States Environmental Protection Agency
USEPA
             upper tolerance limit of a distribution's 95th percentile
UTL95%,95%
             volume/volume
v/v
             volatile organic chemical
VOC
             weight/weight
w/w
             white blood cell (leukocyte)
WBC
             World Health Organization
WHO
             year
y
             microgram
µg
             microlitre
µL
             micromolar
µM
             micromole
µm o l
             8-hydroxydeoxyguanosine
8-OHdG




                                                         Priority Existing Chemical Number 21
                                      xviii

          1. Introduction

1.1       Declaration
          The chemical benzene (CAS No. 71-43-2) was declared a Priority Existing
          Chemical for full assessment under the Industrial Chemicals (Notification and
          Assessment) Act 1989 on 7 April 1998. It was nominated by the public because of
          concerns about its human health effects and the adequacy of the current Australian
          occupational exposure standard.

1.2       Objectives
          The objectives of this assessment were to:
          ·     characterise the properties of benzene;
          ·     determine the uses of benzene in Australia;
          ·     determine the extent of occupational, public and environmental exposure to
                benzene;
          ·     characterise the intrinsic capacity of benzene to cause adverse effects on
                persons or the environment;
          ·     characterise the risks to humans and the environment resulting from exposure
                to benzene; and
          ·     determine the extent to which any risk is capable of being reduced.

1.3       Sources of information
          Consistent with the objectives, this report presents a summary and critical
          evaluation of relevant information relating to the potential health and
          environmental hazards from exposure to benzene. Relevant scientific data were
          submitted by the applicants listed in Section 3, obtained from published papers
          identified in a comprehensive literature search of several online databases up to
          December 2000, or retrieved from other sources such as the reports and resource
          documents prepared for the health surveillance program of the Australian Institute
          of Petroleum (AIP) and the Illawarra leukaemia cluster investigation. Due to the
          availability of several peer-reviewed overseas assessment reports, not all primary
          sources of data were evaluated. However, relevant studies published since the cited
          reviews were assessed on an individual basis.
          The characterisation of health and environmental risks in Australia was based upon
          information on use patterns, product specifications, occupational exposure and
          emissions to the environment made available by applicants and relevant State
          authorities. Information to assist in the assessment was also obtained through site
          visits and telephone interviews. The site visits included two petroleum refineries,
          two petrol terminals, a steelworks, a coal tar distillery, a bulk liquid storage facility
          and three chemical plants.




Benzene                                          1

1.4   Peer review
      During all stages of preparation, the report has been subject to internal peer review
      by NICNAS, Environment Australia (EA) and the Therapeutic Goods
      Administration (TGA). Selected parts of the report were also peer reviewed by
      Professor Tom Beer, CSIRO Atmospheric Research (Sections 8 and 15); Dr
      Stephen Corbett, New South Wales Department of Health (Section 11); Dr Andrea
      Hinwood, Department of Environmental Protection, Western Australia (Sections 9,
      11 and 13); and Professor Martyn T. Smith, University of California (Sections 9
      and 12).




                                                             Priority Existing Chemical Number 21
                                           2

          2. Background

2.1       Introduction
          Benzene is a naturally occurring, hazardous, volatile organic compound which is
          ubiquitous in the environment. It is formed from biomass under the impact of heat,
          pressure and geological time. As such, it is present in fossil fuels which may release
          it to air when unearthed and, in particular, when heated to combustion. Benzene is
          also a product of natural processes and human activities that involve the
          instantaneous thermal degradation of organic matter. These sources of entry include
          bush fires, crop residue and forest management burning, petroleum refining, petrol
          combustion, wood and charcoal fires, fumes from heated cooking oils, tobacco
          smoke, incense, and waste incineration. In addition, benzene enters the
          environment in emissions and waste streams from industrial processes and waste
          disposal facilities.

2.2       International perspective
          Benzene was first isolated in 1825 and gradually became widely used as a solvent
          and starting material for the synthesis of a number of organic chemicals (Folkins,
          1984). Benzene also became recognised as a valuable constituent of petrol because
          of its antiknock properties and ability to increase the octane rating of automotive
          fuels.
          Until World War II, benzene was isolated from light oil, which is a by-product of
          the carbonisation of coal to produce gas for heating or coke for the blast furnaces of
          the steel industry. Beginning in the 1930s, new catalytic and thermal processes for
          the production of aromatic hydrocarbons from crude oil were discovered and
          commercialised in the petroleum industry. With the advent of natural gas in the
          1960s, worldwide coal gas production started to diminish. Simultaneously, the
          introduction of modern steel processing methods decreased coke production and
          made it attractive to burn the light oil as fuel rather than segregate it into benzene
          and other products. In consequence, the petroleum industry is now the predominant
          source of benzene.
          In recent years, the use of benzene-containing solvents has been practically
          eliminated because of the toxicity of the chemical. Current worldwide consumption
          of benzene is 30-35 million metric tonnes (t) per annum, primarily as chemical
          feedstock in the production of large-scale intermediates such as ethyl benzene,
          cumene and cyclohexane (Chemistry & Industry News, 1996). This figure does not
          include benzene produced by the petroleum industry and retained as a petrol
          component.
          Commercial low-grade qualities are sometimes referred to as benzol. Benzene is
          not to be confused with benzine, which is a mixture of several low-boiling
          hydrocarbons obtained in the distillation of petroleum.

2.3       Australian perspective
          Developments in Australia have followed the general pattern outlined above, albeit
          with a delay of 1-2 decades. The recovery of benzene from coal gas is now limited

Benzene                                         3

to the steelworks at Port Kembla in New South Wales and Whyalla in South
Australia.
There are eight petroleum refineries in Australia: two in Brisbane and Sydney and
one in Adelaide, Geelong, Melbourne and Perth. Since the 1970s, close to 100% of
local demand for petrol has been met from crude which is low in aromatic fractions
(Tresider, 1998). As such, all Australian petroleum refineries have processes in
place to increase the content of aromatic hydrocarbons including benzene in their
petrol blendstock. Petroleum-derived benzene feedstock for the chemical industry
is not produced in Australia.
As of 1986, new petrol-driven cars had to be fitted with catalytic converters and use
unleaded fuel. An Australian Standard for petrol for motor vehicles was established
in 1990 and limited the benzene content to a maximum of 5% v/v (Standards
Australia, 1990). In 1998, the average benzene content in Australian petrol was 2.9,
2.6 and 3.3% v/v in leaded petrol (LP), unleaded petrol (ULP) and premium
unleaded petrol (PULP) respectively (AIP, 1998b). The Fuel Quality Standards Act
2000 enables the Commonwealth to make mandatory national quality standards for
fuel supplied in Australia. Among others, these will include a maximum content of
benzene in petrol of 1% v/v from January 1 2006. Meanwhile, Western Australia
and Queensland have introduced regulations limiting the benzene content in petrol
to 1% and 3.5% respectively (EA, 2000b).
In 1980, AIP contracted The University of Melbourne to set up an epidemiological
health surveillance program called Health Watch. The program covers about 95%
of the industry's 18,000 employees in refineries, natural gas plants, distribution
terminals and production sites. It consists of a prospective cohort study of all-cause
mortality and cancer incidence, in addition to a case-control study of lympho-
haematopoietic cancers and benzene exposure established in 1988 (Glass et al.,
1998, 2000; Health Watch, 1998).
Air pollution became a major concern in the 1990s and prompted environment and
health authorities from the Commonwealth, States and Territories to initiate several
research projects into ambient air quality. Early results of this research resulted in
the inclusion of benzene in the National Pollutant Inventory (NPI), which was
established by the National Environment Protection Council (NEPC) in 1998. The
NPI currently comprises 36 chemicals of health and environmental concern which
must be reported to EA if the quantity used or handled per site exceeds a threshold
limit, which for benzene is 10 t per year (EA, 1999b). More recently, the Australian
and New Zealand Environment and Conservation Council contracted the Victorian
Environment Protection Authority (EPA) to assess the available air level data and
derive a risk-based rank order of hazardous air pollutants according to their
priorities for further research (EPA Victoria, 1999). Based on a scoring system as
well as on professional judgement, benzene came first among 15 chemicals
recommended for general urban air monitoring. Benzene is also the subject of a
publication in the series of National Environmental Health Forum Monographs,
which are intended to provide plain language information about important, topical
environmental health matters (Wadge & Salisbury, 1997). Current EA initiatives
such as the Fuel Quality Review and Living Cities ­ Air Toxics Program both
address a number of environmental aspects relating to benzene (EA, 2000a, 2000b).
Public concern about exposure to benzene reached a peak      in 1996, when a cluster
of leukaemia cases was identified in people living in the    suburbs adjacent to the
coke ovens and coal gas by-product plant at the Port         Kembla steelworks. A
committee reporting to the New South Wales Department        of Health was set up to
                                                        Priority Existing Chemical Number 21
                                      4

          investigate the matter. It concluded that based on the available data, it was not
          possible to ascribe the cluster to a particular exposure (including benzene). The
          investigation produced several useful publications relating to benzene and the risk
          of leukaemia (ILISC, 1997; Westley-Wise et al, 1999).

2.4       Assessments by other national or international bodies
          Although there have been restrictions on the manufacture, handling, storage and
          use of benzene in Australia since 1978, this report represents the first
          comprehensive risk assessment by a national agency.
          Benzene has been assessed by several overseas or international bodies involved in
          the review or evaluation of data pertaining to the health and/or environmental
          hazards posed by chemicals. Of these, the most noteworthy are:
          ·   The Advisory Committee to the German Chemical Society on Existing
              Chemicals of Environmental Relevance (GDCh, 1988);
          ·   The Agency for Toxic Substances and Disease Registry under the US
              Department of Health and Human Services (ATSDR, 1997);
          ·   The Commission of the European Communities (EC, 1989, 2000);
          ·   Environment and Health Canada (Government of Canada, 1993);
          ·   The International Agency for Research on Cancer (IARC, 1982a, 1987);
          ·   The International Programme on Chemical Safety (IPCS, 1993);
          ·   The UK Department of the Environment (DoE, 1994);
          ·   The US Environmental Protection Agency (USEPA, 1985, 1998a, 1998c); and
          ·   The OECD SIDS International Assessment Report (draft) (OECD, 2000).




Benzene                                       5

3. Applicants

Following the declaration of benzene as a Priority Existing Chemical, 21
companies or organisations applied for assessment of the chemical. The applicants
supplied information on the properties, import and manufacturing quantities and
uses of benzene and, in some cases, on occupational exposures and releases to the
environment. In accordance with the Industrial Chemicals (Notification and
Assessment) Act 1989, NICNAS provided the applicants with a draft copy of the
report for comments during the corrections/variation phase of the assessment. The
applicants were as follows:

                                             Koppers Coal Tar Products Pty Ltd
Alltech Associates (Australia) Pty Ltd
                                             PO Box 23
PO Box 6005
                                             Mayfield NSW 2304
Baulkham Hills NSW 2153

Australian Institute of Petroleum            Merck Pty Ltd
                                             207 Colchester Rd
GPO Box 279
                                             Kilsyth VIC 3137
Canberra ACT 2601
                                             Mobil Oil Australia Pty Ltd
Australian Council of Trade Unions
                                             417 St Kilda Rd
393 Swanston Street
                                             Melbourne VIC 3004
Melbourne VIC 3000

                                             BHP Steel ­ Flat Products
Australian Manufactures Workers Union
                                             PO Box 1854
3/440 Elizabeth Street
                                             Wollongong NSW 2505
Melbourne VIC 3000
Bio-Scientific Pty Ltd                       Qenos Pty Ltd
PO Box 78                                    Private Bag 3
Gymea NSW 2227                               Altona VIC 3018

BP Australia Holding Limited                 Selby-Biolab
360 Elizabeth St                             Private Bag 24
Melbourne VIC 3000                           Mulgrave North VIC 3170
Caltex Petroleum Australia Pty Ltd           Sigma-Aldrich Pty Ltd
19-29 Martin Pl                              PO Box 970
Sydney NSW 2000                              Castle Hill NSW 2154
                                             Terminals Pty Ltd
Crown Scientific Pty Ltd
                                             PO Box 268
Private Mail Bag 4
                                             Footscray VIC 3011
Moorebank NSW 2170
                                             3M Australia Pty Ltd
Huntsman Chemical Company Australia
                                             PO Box 144
Pty Ltd
                                             St Marys NSW 2760
PO Box 62
West Footscray VIC 3012

                                             Trafigura Fuels Australia Pty Ltd
ICN Biomedicals Australasia
                                             Unit 2, 47 Epping Rd
PO Box 187
                                             North Ryde NSW 2113
Seven Hills NSW 2147

Whyalla Steelworks (OneSteel
Manufacturing)
PO Box 21
Whyalla SA 5600




                                                       Priority Existing Chemical Number 21
                                         6

          4. Chemical Identity and
             Composition

4.1       Chemical name (IUPAC)
          Benzene

4.2       Registry numbers
          Benzene is listed on the Australian Inventory of Chemical Substances (AICS) as
          benzene.
          CAS number                            71-43-2
          EINECS number                         200-753-7
          UN number                             1144

4.3       Other names
          Annulene
          Benzol(e)
          Bicarburet of hydrogen
          Carbon oil
          Coal naphtha
          Cyclohexatriene
          Mineral naphtha
          Motor benzol
          Phenyl hydride
          Pyrobenzol(e)

4.4       Molecular formula
          C6H6

4.5       Structural formula




                            or




Benzene                                     7

4.6   Molecular weight
      78.11

4.7   Composition of commercial grade product
      Several different grades of benzene are commercially available. The principal
      impurities are toluene, xylenes and other hydrocarbons with boiling points similar
      to that of benzene. The higher the grade, the lower the content of thiophene
      (thiofuran) and other sulfur compounds, which foul many catalysts used in
      reactions of benzene (Fruscella, 1992). The specifications for two typical import
      grades and the benzene/toluene/xylenes (BTX) mixture produced at the Port
      Kembla steelworks are shown in Table 4.1.
      Table 4.1: Raw material specifications for some commercially available
      benzene grades


       Test                          Pure benzene     Crude benzene              BTX
       Benzene (% v/v)                    >99              95                    80
       C9 & higher (% v/v)                 -               <1.5                  <1.6
       Carbon disulfide (ppm)              -               <50                  <4000
       H2S & SO2                         None                -                     -
       Non-aromatic C5-C6 (% v/v)        <0.15             <0.7                  <1.5
       Styrene (% v/v)                     -                 -                   <1.8
       Thiophene (ppm)                    <1              <6000                 <6000
       Toluene (% v/v)                     -                 -                  <12.5
       Total sulfur (ppm)                  -                 -                  <6000
       Xylenes & styrene (% v/v)           -                 -                   <3.8




                                                           Priority Existing Chemical Number 21
                                          8

          5. Physical and Chemical
             Properties

5.1       Physical state
          Benzene is a volatile, colourless and flammable liquid with a characteristic, sweet
          aromatic odour (Budavari, 1996). The odour threshold ranges from 0.8-160 ppm
          (AIHA, 1989); 50% of the population can identify the odour at 2 ppm and 100% at
          5ppm (Verscheuren, 1996). The physical properties of benzene are summarised in
          Table 5.1.
          Conversion factors (at 25°C):
          1 mg/m3 = 0.31 ppm and 1 ppm = 3.2 mg/m3 (Cavender, 1994).

5.2       Physical properties
          Table 5.1: Physical properties


           Property                                     Value             Reference

           Melting point                               5.53ºC             Folkins (1984)
           Boiling point                               80.1ºC             Folkins (1984)
           Density
                                                      0.885 kg/L          Fruscella (1992)
           ·  at 15ºC
                                                      0.879 kg/L
           ·  at 20ºC
                                                      0.874 kg/L
           ·  at 25ºC
           Vapour density                     2.8 (relative to air = 1)   Cavender (1994)
           Vapour pressure
                                                      3.47 kPa            Folkins (1984), Fruscella
           ·  at 0ºC
                                                      9.97 kPa            (1992)
           ·  at 20ºC
                                                      12.6 kPa
           ·  at 25ºC
                                                      24.2 kPa
           ·  at 40ºC
                                                      35.8 kPa
           ·  at 50ºC
           Water solubility (at 25ºC)                  1.80 g/L           IPCS (1993)
                                                                3
           Henry's Law constant (at 20ºC)        0.56 kPa.m /mol          Mackay & Leinonen (1975)
           Partition coefficient (log Po/w)           1.56-2.15           IPCS (1993)
           Sorption coefficient (log Koc)              1.8-1.9            IPCS (1993)
           Flash point (closed cup)                    ­ 11ºC             Fruscella (1992)
           Autoignition temperature                     560ºC             Fruscella (1992)
           Explosive limits
                                                                    3
                                               1.4% v/v (45 g/m )         Cavender (1994)
           ·   lower
                                                                3
                                               7.9% v/v (250 g/m )
           ·   upper


5.3       Chemical properties
          The six carbon atoms of benzene form a regular hexagon and all 12 atoms lie in a
          single plane, with all bond angles being exactly 120° (Fruscella, 1992). The
          molecule is traditionally depicted as having alternating single and double bonds
          (see structure (1) in Section 4). However, as the six carbon-carbon bonds are
Benzene                                           9

physically and chemically identical and intermediate in length between single and
double bonds (as indicated by structure (2) in Section 4), benzene does not react as
a typical unsaturated compound.
Benzene has great thermal stability and elevated temperatures are required for its
decomposition. It undergoes substitution and addition reactions and ring cleavage.
For industrial applications, the most important reactions are alkylation with
ethylene or propylene to produce ethyl benzene or cumene, hydrogenation to
cyclohexane, nitration and sulfonation to form nitrobenzene and benzenesulfonic
acid, and halogenations. Benzene cannot be hydrolysed.
Benzene is miscible with numerous other organic solvents including alcohol,
acetone, diethyl ether, ethyl acetate, chloroform, carbon disulfide, glacial acetic
acid and oils (Budavari, 1996). Its solubility in water ranges from 1.13% v/v at
25°C to 5.07% v/v at 107°C (Folkins, 1984). Benzene forms binary and tertiary
azeotropes with water and a large number of organic substances (for examples, see
Folkins (1984)).
Benzene is highly flammable and potentially explosive. Combustion products
include carbon dioxide, water vapour and carbon monoxide. With a deficiency of
air or oxygen, partial decomposition and soot deposition occur (Folkins, 1984).
Vapours burn with a sooty flame.




                                                       Priority Existing Chemical Number 21
                                    10

          6. Methods of Detection and
             Analysis

6.1       Characterisation
          Benzene can be characterised by infrared, ultraviolet and mass spectrometry and
          nuclear magnetic resonance techniques (Fruscella, 1992).

6.2       Detection and analysis
          A time-honoured spot test for benzene in the workplace or surroundings involves
          the treatment of a sample with nitric acid followed by ether extraction and
          dissolution in a mixture of alcohol and methyl ethyl ketone. Benzene is converted
          to m-dinitrobenzene which imparts a persistent red colour to the solution (Dolin,
          1943, cited in Fruscella, 1992).
          Standard analytical methods for benzene in air, water, soil, foods, smoke,
          biological samples, petroleum products etc. rely on gas chromatography (GC) with
          flame or photo ionisation detection, or on gas chromatography-mass spectrometry
          (GC-MS) (Fruscella, 1992; IPCS, 1993). Benzene in water, soil and food is usually
          measured by a purge and trap method by bubbling an inert gas through the sample
          and collecting the chemical on an absorbent. Benzene is then desorbed and
          determined. The best available GC methods are able to detect benzene at 0.1 ppb in
          air or 1 ng/kg in liquid or solid media, although 3 ppb in air and 1µg/L in water are
          the limits of detection in routine analysis (IPCS, 1993; NHMRC, 1996). The GC-
          MS method is not quite as sensitive, but more reliable in the case of samples with
          multiple components with retention times similar to that of benzene (IPCS, 1993).

6.3       Atmospheric monitoring methods

          In the environment

          The methods commonly used for measuring the concentration of benzene in
          ambient air fall into the following two categories (EPA Victoria, 1999):
          (1) discrete air sampling with subsequent laboratory analysis; or
          (2) continuous or semi-continuous in-field analysis.
          Among the former, the most widely used method involves the collection of air into
          a stainless steel canister over a predetermined period of time such as 24 h, followed
          by analysis of a concentrate of the air sample by GC or GC-MS. This method is
          described in more detail by DEP Western Australia (2000).
          A commonly used continuous method for in-field analysis utilises an optical remote
          sensing system to determine the concentration of the chemical by means of the
          differential absorption of transmitted light by gaseous compounds along the light
          path. The system consists of a light transmitter and sensor placed at a given
          distance apart at the monitoring site.
          Alternatively, the concentration in air can be analysed by semi-continuous gas
          chromatography. Samples of air are collected directly onto solid absorbents,
Benzene                                        11

desorbed thermally onto the GC column and analysed while the next sample is
collected.
The analytical limit of detection of the above methods typically ranges from 0.003-
0.1 ppb. All of the methods allow for the simultaneous determination of several
other gaseous air pollutants in the same sample. Discrete sampling methods
determine average pollutant levels over the sample collection time. Continuous or
semi-continuous methods enable more detailed information about concentration
variations to be obtained.

In the workplace

This section summarises the methods commonly used for the measurement of
benzene in the workplace. Other past and present techniques are described in a
recent review by Verma & des Tombe (1999a, 1999b).
For personal monitoring during full shifts or tasks, workers are equipped with a
charcoal tube or badge placed in the breathing zone. For area monitoring, the tube
or badge is placed at a fixed location in the workplace environment. Tubes are
connected with a portable metering pump, whereas badges sample the air by
diffusion. At the end of the sampling period, the tube or badge is sealed and
transferred to a laboratory, where the chemical is liberated from the absorbent by
elution or thermal desorption and quantified by GC (NIOSH, 1994). The result is
expressed as a time-weighted average (TWA) concentration in ppm or mg/m3 over
the duration of the sampling period. The analytical detection limit depends on the
airflow across the absorbent and the duration of the sampling period. The detection
limit using charcoal tube sampling and analysis according to the NIOSH method is
0.02 ppm.L, or 0.004 ppm for a sample collected over 60 min at a pump speed of
80 mL/min (IPCS, 1993). The agreement between the tube and badge methods is
not perfect, but the differences are generally of little importance (Hotz et al., 1997;
Purdham et al., 1994).
`Grab sampling' or instantaneous measurement of the concentration of airborne
benzene is conducted with colorimetric detector tubes. These are glass tubes sealed
at both ends with a graduated concentration scale etched into the outer surface. The
tubes contain a carrier material covered with chemical reagents that react with
benzene to produce a colour change whose end-point is read against the scale. Prior
to use, the seals are broken, the tube is connected to a hand pump and the pump is
operated to draw a defined amount of air through the tube. A colorimetric detector
has become available which can measure benzene at 0.2 ppm in the presence of
other hydrocarbons, with a measuring time of 8 minutes. Non-selective
photoionisation detectors can be used for instantaneous measurement of benzene
concentrations with a detection limit of approximately 0.1 ppm but, because the
detector also responds to volatile organic chemicals, they are limited to situations
where the vapour is known to be pure benzene. Recently, a benzene-selective
photoionisation detector has become available which is claimed to be able to
measure benzene at concentrations of 0.1 ppm ­ 200 ppm in the presence of other
hydrocarbons within approximately 1 minute. The detector uses a single use pre-
treat tube to filter out interfering hydrocarbons except for  C3 alkanes and must be
calibrated against 5 ppm benzene prior to use.
A less widely used method is continuous area monitoring, which is performed by
pumping air collected at one or more fixed locations through an auto analyser
equipped with an ultraviolet spectrometer. This method delivers readings for TWA


                                                         Priority Existing Chemical Number 21
                                      12

          as well as peak concentrations and has a limit of detection of approximately 0.2
          ppm (IPCS, 1993).

6.4       Biological monitoring methods
          Biological monitoring for benzene exposure involves the measurement of
          unmetabolised benzene in blood, urine or breath samples, of benzene metabolites in
          the urine, or of protein adducts with the benzene oxide metabolite.
          The concentration of benzene in venous blood and urine can be determined by GC,
          with a detection limit of around 0.5 µg/L (IPCS, 1993). For the determination of
          benzene in breath air, an end-exhaled sample is collected and analysed by GC-MS,
          with a detection limit of 3-6 ppb (Money & Gray, 1989). However, these methods
          are only suitable for research purposes, as great care must be exercised to avoid
          contamination of the samples with ambient benzene.
          Various metabolites are excreted in the urine, including phenol, hydroquinone and
          catechol conjugates, S-phenylmercapturic acid and trans,trans-muconic acid (see
          Section 9.3), although none of them is formed exclusively from benzene. These
          metabolites can be quantified by GC, GC-MS or high-performance liquid
          chromatography as described by Ducos et al. (1990), Hotz et al. (1997), Lee et al.
          (1993), Popp et al. (1994) and others. Whereas the urinary concentration of phenol
          has been widely used as an index of benzene exposure, the background levels make
          it unreliable at exposures <5-10 ppm. The concentration of S-phenylmercapturic
          acid or muconic acid relative to creatinine in an end-of-shift urine sample has been
          shown to be a fairly good indicator of exposure in the 0.25-1 ppm range, even in
          smokers (Ghittori et al, 1995; Hotz et al, 1997; Ong et al, 1996).
          The metabolite benzene oxide binds to nucleophilic sites and forms phenyl cysteine
          residues with proteins such as haemoglobin and albumin (see Section 9.3.1). The
          concentration of such adducts in blood correlates with benzene exposure. However,
          high background levels severely limit the practical use of the S-phenyl cysteine
          adduct as a biological marker for benzene uptake (Yeowell-O'Connell et al, 1998).




Benzene                                       13

      7. Manufacture, Importation and
         Use

7.1   Manufacture and importation
      Benzene is introduced into Australia through extraction, importation and
      manufacture.
      The total Australian production of crude in 1994-98 is shown in Figure 7.1. Crude
      includes unrefined oil as well as condensate, which is a liquid mixture of
      hydrocarbons recovered from gas wells. The mean annual and 1998 volumes are
      both approximately 31,000 ML. Australian crude is reported to have a low benzene
      content, estimated at about 0.1% v/v (Glass et al, 1998). As such, the annual
      extraction of benzene from Australian oil and gas fields can be estimated at
      approximately 31 ML. As the density of benzene is around 0.88 kg/L, this
      corresponds to a quantity of 27 kilotonnes (kt) pure benzene.
      Figure 7.1: Australian production of crude oil and condensate 1994-98 (AIP,
      1999b)


                     34
                     33
                     32
         ML x 1000




                     31
                     30
                     29
                     28
                     27
                          1994    1995        1996       1997         1998         M ean


      The throughput of crude at Australian refineries in 1998 was 44,678 ML, of which
      62% was of non-Australian origin (AIP, 1999a). Most of the imports come from oil
      fields in the Pacific basin and contain approximately the same concentration of
      benzene as Australian crude, that is, about 0.1% v/v (Glass et al, 1998). This
      corresponds to a total input of 45 ML or 39 kt pure benzene.
      From these figures, it can be concluded that Australia is a net importer of benzene
      in crude to the tune of approximately 12 kt per annum.
      Table 7.1 shows the throughput of benzene-containing gasoline products, that is,
      leaded petrol (LP), unleaded petrol (ULP), premium unleaded petrol (PULP) and
      light aircraft gasoline (Avgas), at Australian refineries in 1998. The table also gives
      the average content of benzene and the corresponding quantities of pure benzene.
      Data for Avgas are estimates, but have little impact on the total. Other petroleum
      products such as liquefied petroleum gas, kerosene, civil aviation jet fuel, diesel oil,
      fuel and heating oils and lubricants contain no or practically no (<0.02% v/v)
      benzene (AIP, 1999a; IARC, 1989; Potter & Simmons, 1998).
      The volume of pure benzene in petrol produced at Australian refineries in 1998 was
      484 ML, corresponding to 426 kt pure benzene. As the throughput crude contained
                                                               Priority Existing Chemical Number 21
                                            14

          approximately 39 kt pure benzene, it can be concluded that the production of
          benzene in the Australian petroleum industry amounted to 387 kt in 1998.

          Table 7.1: Throughput of LP, ULP, PULP and Avgas at Australian refineries in
          1998 (AIP, 1998b, 1999b)


                                         LP            ULP           PULP          Avgas            Total

          Petrol (ML)                   4965          12,218          640            100           17,923
          Benzene (% v/v)                2.9              2.6         3.3            1.0              -
          Pure benzene (ML)             144            318             21             1              484

          Petrol is also imported in finished form. From January 1994 through August 1999,
          petrol imports averaged 680 ML per annum (DISR, 1999). There is no information
          on the benzene content of imported petrol, but it is unlikely to differ much from
          that of Australian ULP, which averages 2.6% v/v. As such, annual imports of
          benzene as an ingredient in petrol purchased overseas is estimated at 18 ML
          corresponding to approximately 15 kt pure benzene.
          The Port Kembla steelworks produces 20-22 ML per annum of a commercial low-
          grade benzene product called BTX. As the specifications stipulate a benzene
          content of 80% v/v (Table 4.1), this corresponds to approximately 14.0-15.5 kt
          pure benzene per annum. The Whyalla steelworks no longer produce BTX,
          however, 0.12kt of benzene per annum, from the naphthalene still, is reinjected into
          the fuel gas stream.
          Benzene is also produced as a by-product stream component at two olefins
          (pyrolysis) plants belonging to Qenos Pty Ltd. The total quantity amounts to
          approximately 15 kt per annum, all of which is exported for use or further
          processing overseas.
          The only importer of benzene feedstock is Huntsman Chemical Company, whose
          annual imports are stable at about 50 kt pure benzene and 30 kt crude benzene
          (95% v/v), that is, approximately 80 kt pure benzene per annum.
          Minor quantities not exceeding 1 t in the aggregate are imported for laboratory and
          other small-scale uses, as described below.

7.2       Manufacturing processes and end use

7.2.1     Petroleum industry
          Table 7.2 provides an overview of the location and ownership of the currently
          operating oil refineries in Australia, as well as a summary of the processes
          employed to produce benzene, their capacity, and the benzene content of locally
          produced petrol. The latter is taken from a 1994 survey, which reported the
          concentration in % w/w (Tresider, 1998). As such, it is not directly comparable to
          the data provided in Table 7.11. The process technologies and end use of the
          benzene produced are described below.




          1
            The factor needed to convert % w/w to % v/v varies with the density of the petrol. Based on the
          average density of Australian petrol in 1999, multiplication of the concentration in % w/w with 0.84
          will give an approximate concentration in % v/v (Exxonmobile personal communication, 2001).
Benzene                                              15

Table 7.2: Benzene processes at Australian oil refineries (AIP, 1997; Mobil,
2000; Tresider, 1998)

                                                                                Benzene in
                                          Benzene           Capacity
                                                                           LP/ULP/PULP (% w/w)
State      Location           Owner       technology         (kt/y)*
NSW        Clyde               Shell      Reforming             890               2.7/ 2.4/3.6
                                          Cracking             1558
           Kurnell            Caltex      Reforming            1344               2.3/2.3/4.7
                                          Cracking             2024

QLD        Bulwer Island      BP          Reforming             588               2.5/3.7/5.0
                                          Cracking              912
           Lytton             Caltex      Reforming            1157               2.4/2.5/4.4
                                          Cracking             1469

                                          Reforming
SA         Port Stanvac        Mobil                           1157               2.3/2.0/2.5

VIC        Altona             Mobil       Reforming            1380               4.8/4.5/5.5
                                          Cracking             1246
           Geelong            Shell       Reforming            1380               3.6/3.6/5.4
                                          Cracking             1780

WA         Kwinana            BP          Reforming             979               1.9/2.0/2.2
                                          Cracking             1456

* The capacity is calculated on the basis of 350 stream days per year and refers to the quantity of raw
material processed, not benzene produced.


Based on more recent information (AIP average data for 1999), ULP contains
approximately 3.01% (w/w) benzene, PULP contains 4.02% (w/w) and LP contains 3.46
(w/w) (Exxonmobile Personal Communication, 2001).

Petroleum refining

Petroleum refining involves a series of continuous, enclosed processes designed to
convert crude oil and condensate into end products such as liquefied petroleum gas,
Avgas, petrol, jet fuel, diesel, heating oil, lubricants and bitumen. The main
processes designed to augment the content of aromatics such as benzene in petrol
are shown in the flowchart in Figure 7.2 and summarised below.
Figure 7.2: Benzene production in petroleum refineries

                           Isobutane

               Distillation
 CRUDE                                     Straight run gasoline


               30-105°C
                                                                            PETROL AND
                                           Catalytic                          AVGAS
                                  Naphtha reforming                           BLEND-
                                                                              STOCKS
              105-155°C


               Vacuum
                                                    Catalytic
              distillation                                                   Alkylation
                                                    cracking
                                   Heavy
                                   gas oil
              340-425°C

                                                                   Priority Existing Chemical Number 21
                                             16

          At all refineries, crude oil is first separated into a number of fractions by
          atmospheric and vacuum distillation. Petrol is a blend of butane, refined naphthas,
          isomerate, reformate, cracked gasoline and alkylate. Avgas is primarily made from
          alkylate although reformate can also be used.
          The straight run gasoline fraction contains a 5- to 10-fold concentrate of all the
          benzene that was present in the crude, corresponding to a benzene concentration of
          0.5-1% v/v.
          The naphtha fraction, which contains many cyclic, saturated hydrocarbons,
          undergoes catalytic reforming in a process using heat, pressure and a platinum
          catalyst to convert a portion of the feedstock to aromatic compounds. The resulting
          reformate typically contains 4-8% v/v of benzene (Audrey, 1994).
          At the Mobil Altona refinery, part of the heavy gas oil fraction is piped to a nearby
          petrochemical plant for steam cracking, as described below. This process gives rise
          to a by-product known as steam cracked naphtha or pyrolysis gasoline, which
          contains 6-8% benzene. This by-product stream is piped back to the oil refinery
          where it is stored in floating-roof tanks and eventually exported to overseas
          customers by shipping tanker.
          The heavy gas oil fraction, which contains large, high boiling hydrocarbon
          molecules, is cracked to a mixture of lower molecular weight compounds by means
          of heat, pressure and a silica/aluminium oxide or zeolite catalyst. The benzene
          content of cracked gasoline rarely exceeds 1-2% v/v, but varies depending on the
          composition of the feedstock, the nature of the catalyst and the temperature and
          pressure conditions. As shown in Figure 7.2, some of the output from the cracking
          process is reacted with isobutane to form larger branched-chain molecules
          (isoparaffins) that increase the octane rating of the final petrol blend. The alkylation
          process does not augment benzene content.
          Eventually, the various petrol feedstock qualities are blended to produce end
          products with the desired specifications. These vary according to the likely ambient
          temperatures in the area and season in question and generally require higher
          concentrations of aromatic components such as benzene in colder climates.
          Feedstock and end product are stored in tanks equipped with floating roofs or
          connected to vapour recovery systems. The end products are distributed to larger
          terminals by pipeline, in coastal tankers or bottom-loaded rail tankers and/or to
          local depots and service stations in road tankers, the majority of which are bottom
          loaded. In rural areas not all road tankers are bottom loaded. Terminals in Sydney,
          Melbourne and Perth have vapour recovery systems to minimise vapour emissions
          during truck filling operations. There were 8233 petrol retail outlets in Australia at
          the end of 1998 (AIP, 2000).

          End use

          In Australia, all benzene produced by petroleum refiners is retained as one of several
          aromatic components in automotive petrol and Avgas; most of this benzene is burnt
          during normal engine operation. Figure 7.3 shows the total demand for benzene-
          containing petroleum products in 1996, and its breakdown by State marketing area2.

          2
            The State marketing area (SMA) of Queensland includes the Murwillumbah district of NSW, which
          is supplied from the refineries in Brisbane. The SMA of South Australia includes the Broken Hill-
          Wilcannia district of NSW and the Murrayville district of Victoria, which are supplied from the
          refinery at Port Stanvac. The SMA of Victoria includes the Riverina district of New South Wales,
Benzene                                             17

Figure 7.3: Demand for petrol in 1996 (AIP, 1997)


                                                                    NT
                     NT
                                                               TAS
                   TAS
                                                              WA
              WA
                                     NSW
                                                        SA                         NSW
         SA



                                                      QLD
        QLD

                                                                         VIC
                               VIC

                   LP: 6782 ML                               ULP: 10,847 ML


                        TAS
                                                               NT
                              NT
                   WA                                                           NSW
                                                         TAS
              SA

                                                      WA
                                       NSW
                                                                                      VIC
         QLD

                                                         SA

                                                                         QLD
                     VIC


                   PULP: 338 ML                                Avgas: 102 ML



As expected, the demand for petrol is highest in the most populous States of New
South Wales and Victoria. Queensland, Western Australia and the Northern
Territory account for more than one-half of the total demand for Avgas.
Since catalytic converters became mandatory on new cars in 1986, there has been a
steady increase in the demand for ULP and a corresponding decline in the demand
for LP. However, although LP contains more benzene than ULP, the corresponding
fall in benzene consumption has been counterbalanced by an overall growth in
petrol demand. PULP, which was first produced in significant quantities in 1989
and has the highest concentration of benzene (Table 7.1), accounted for only 2% of
total petrol sales in 1996, almost half of which was generated in New South Wales.
However, PULP demand is expected to grow as LP is phased out nationally by
2002 and pre-1986 cars will need to run on either PULP or lead replacement petrol,
that is, PULP pre-blended with an anti-valve seat recession additive.
The likely impact of the predicted changes in demand on the use of benzene in
petrol can be estimated on the basis of AIP's petrol sales forecasts for the decade
1998-2007 (AIP, 1998a). If current benzene concentrations are assumed to remain


which is supplied from the refineries at Altona and Geelong. The SMA of New South Wales includes
the Australian Commonwealth Territory.
                                                               Priority Existing Chemical Number 21
                                           18

          unchanged throughout the period, total benzene use in petrol is estimated to
          increase from 434 kt/y in 1998 to 461 kt/y in 2007. However, if a nationwide
          standard is introduced limiting the maximum content in petrol to 1%, total benzene
          use in petrol is estimated to fall to 176 kt/y in 2007.

          Independent petrol retailers

          The main imports of petrol are marketed by independent chains or supermarkets
          such as Trafigura (formerly Burmah) Fuels, Liberty and Woolworths, who had 564
          service stations between them at the end of 1998 (AIP, 2000). Their imports pass
          through the terminals of Vopak (formerly Van Ommeren) at Port Botany in Sydney
          and Hastings Point near Melbourne, Gull at Kwinana in Western Australia, and
          Fletcher Challenge in Brisbane. These terminals have a petrol storage capacity of
          95, 70, 53 and 13 ML respectively (DISR, 1999; Vopak, 2000).

7.2.2     Steel and associated industries

          BTX

          In the steel industry, BTX is a by-product from volatile fractions produced in the
          coking ovens. It contains 80% v/v benzene (see Table 4.1) and is recovered in an
          enclosed process which yields from 3-5 kg pure benzene per t coke produced.
          The coking ovens are arranged in batteries, each of which may contain in the region
          of 60 units. The ovens are sequentially charged by means of mechanical hopper
          systems through special lidded holes that are closed and sealed to keep out air
          during the coking cycle. This cycle takes place at 900-1100°C for 12-24 h. On
          completion of the cycle, the hot coke is removed mechanically through doors on
          the sides of the oven and sprayed with flushing liquor (a dilute solution of ammonia
          in water) to quench combustion upon exposure to air.
          The coke oven gas contains hydrogen, methane, carbon monoxide and light oil,
          which is a mixture of various aliphatic and aromatic hydrocarbons, including
          benzene. The overhead gas is collected into a pipe that runs along the length of
          each battery and propelled to the by-product plant. At emission, it has a
          temperature of approximately 600°C which is brought down to 80°C by spraying
          with flushing liquor. It is further cooled to 38°C, passed through an electrostatic
          precipitator and an acid scrubber where tar and ammonia are removed and cooled
          to a final temperature of 20°C. The gas then passes to a system of light oil
          scrubbers, where most of the C5 and higher hydrocarbons are recovered by counter-
          current absorption using a high-boiling (300-400°C) petroleum fraction. BTX is
          recovered from the absorbent oil by steam stripping and separated from the water
          by distillation. At Port Kembla, the distillation process is continuous and BTX is
          collected and piped to a storage tank. At the smaller Whyalla steelworks, BTX is
          separated by batch distillation and returned directly to the gas system. At both sites,
          the refined coke oven gas is stored in a gasholder and used for heating.
          Process waste water, which is mainly from the flushing liquor circuit and contains a
          number of contaminants, including benzene, is passed through a water/oil separator
          and discharged to a biological treatment plant. All storage tanks are eventually
          vented to the atmosphere, but may be connected to a vent header with a sealpot
          arrangement to prevent emission unless there is a build-up of pressure. Excess gas
          is flared off.



Benzene                                        19

        All BTX produced at Port Kembla is transported by road to Huntsman Chemical
        Company in Melbourne for use as chemical feedstock.



        Coal tar

        Tar condensed from the coke oven gas and flushing liquor circuit is collected in a
        system of decanting tanks and pumped to a wet tar storage tank. This tank decants
        excess liquor back to the liquor circuit and transfers the tar sediment to a dry tar
        tank farm. The residue from the BTX distillation, which is known as naphthalene
        oil, is also pumped to the dry tar tank farm. The dry tar, which contains 0.16%
        residual benzene, is shipped to Koppers Coal and Tar Products at Mayfield,
        Newcastle, New South Wales, in splash top loaded rail or road tankers, or by sea
        tanker.
        The Newcastle plant receives in the order of 125 kt crude tar per annum containing
        about 145 t residual benzene. The plant comprises two interconnected, fully
        enclosed systems which separate the tar in a series of continuous distillation
        processes. The distillation products include solvent naphtha (4% benzene), distilled
        tar (0.5% benzene), creosote oil (0.2% benzene), naphthalene (no measurable
        benzene) and coal tar pitch (no measurable benzene). Most of the solvent naphtha
        representing about 80% of the benzene received is burnt as fuel. The remainder is
        blended into creosote oil which is used in solvent-based industrial timber
        preservatives or as feedstock in the manufacture of carbon black. Distilled tar is
        used in the coatings industry. Naphthalene is exported and coal tar pitch onsold to
        the aluminium industry for the manufacture of carbon electrodes.
        Process waste water from the Koppers coal tar plant is passed through a water/oil
        separator and discharged to a biological treatment plant. All storage tanks are
        connected to fume scrubbing systems. Off-gases from the stills are burnt as fuel.

7.2.3   Chemical industry

        Qenos

        Ethane and naphtha (gas oil) cracking

        The olefins plant at the Qenos site at Altona in Melbourne produces 10-12 kt
        benzene per year as a by-product of the steam cracking of ethane and naphtha (gas
        oil) to ethylene, propylene and butadiene, which are then converted into plastics
        and rubbers. The Qenos (formerly Orica) olefins plant at Botany in Sydney
        produces 2-3 kt benzene per year as a by-product of the steam cracking of ethane to
        ethylene.
        Steam cracking is a continuous, fully enclosed process which produces a variety of
        products by free radical reactions. Steam and hydrocarbon feedstock are mixed and
        subjected to a brief surge of extreme heat (750-900°C). The effluent is rapidly
        cooled, compressed, purified in a caustic washer, dried, chilled and fractionated in
        a train of distillation columns.
        At the Altona plant, the by-product streams from the ethane and naphtha steam
        cracking processes are combined and purified by distillation to produce a pyrolysis
        gasoline containing 6-8% benzene, which is piped to the Mobil Altona refinery and
        eventually exported for use overseas (Section 7.2.1).


                                                               Priority Existing Chemical Number 21
                                            20

          At the Botany plant, the heavier molecules produced in the cracking process are
          collected in a feed tank and further processed in a fully enclosed system which is
          on stream for approximately 60 days per annum. In the process, the by-product
          stream is hydrogenated and then distilled to remove light ends, which are returned
          to the ethane cracking system. The end product is a pyrolysis gasoline containing
          approximately 55% aromatics including 35-36% benzene. This is stored on site in a
          floating-roof tank. At intervals of 5-6 months, it is piped to the bulk liquid terminal
          at Port Botany and shipped overseas for further processing.

          Butadiene rubber manufacture

          Qenos' Altona facility also uses about 40 t benzene per year as a solvent
          component in the manufacture of butadiene rubber. The benzene is purchased from
          Huntsman (see below) and supplied by dedicated road tanker. It is stored in a
          nitrogen-blanketed tank and pumped to the butadiene rubber plant via sealed pipes.
          In the plant, butadiene is polymerised in solution in a fully enclosed batch process.
          The solvent contains cyclohexane and benzene in a ratio of about 2:1 and is not
          consumed in the reaction. The polymerisation process is strongly exothermic and
          the reactor temperature is kept at approximately 20°C by ammonia cooling. The
          reaction is stopped with an antioxidant. The solvent is removed from the rubber-
          solvent solution by steam stripping and is then condensed, purified and recycled to
          the beginning of the process for feedstock blending. Waste water is steam stripped
          to remove dissolved benzene prior to discharge to sewer. Off-gases containing
          benzene are sent to a thermal oxidiser for destruction.

          Huntsman Chemical Company

          The Huntsman (formerly Chemplex) plant at West Footscray in Melbourne
          converts about 80 kt benzene per annum to ethyl benzene and 10-15 kt to cumene
          (isopropyl benzene). Ethyl benzene is further processed to styrene, which is used in
          the production of polystyrene polymers and unsaturated polyester and vinyl ester
          resin solutions. Cumene is oxidised to acetone and phenol. The phenol is used on
          site in the production of phenol-formaldehyde resins. The acetone is onsold in bulk
          to other manufacturers.
          Huntsman purchases about 15% of their requirements for benzene in the form of
          BTX produced at the Port Kembla steelworks. The remainder is imported from
          Indonesia, Japan, Korea and Singapore in chemical tankers. The bulk chemical is
          unloaded at Terminals Pty Ltd on Coode Island on Melbourne's waterfront where it
          is kept in storage before being transported to Huntsman by dedicated road tanker. A
          small part is trucked to Qenos' Altona facility for use as a solvent component in the
          manufacture of butadiene rubber.

          Styrene manufacture

          The styrene plant was commissioned in 1977 and operates a series of four
          continuous, fully enclosed processes, namely, ethylene, Litol, alkylation and
          dehydrogenation. The principal feedstocks are ethane, pure benzene and BTX.
          In the Litol plant, BTX is vaporised with hot hydrogen and passed through fixed
          bed catalytic reactors to hydro-dealkylate toluene and xylenes to benzene and
          destroy heterocyclic compounds. Pure benzene is recovered by fractional
          distillation. By-product hydrocarbon gases, excess hydrogen and heavy distillation
          residues are used as fuel. A waste stream rich in hydrogen sulfide is incinerated.

Benzene                                        21

        The alkylation plant makes ethyl benzene from benzene and ethylene produced on
        site by the cracking of ethane. In the first of two reactors, the alkylation is carried
        out in the presence of a homogenous acidic catalyst prepared separately from
        aluminium chloride. In the second reactor, recycled polyethyl benzene is trans-
        alkylated to ethyl benzene. The remaining undesired components from the dilute
        ethylene benzene stream are recovered, neutralised and used as fuel. Catalyst is
        removed from the alkylated liquor in a 3-stage wash system. The aqueous wash
        liquors containing aluminium and sodium chlorides and some hydrocarbon
        contaminants are treated aerobically at the site effluent treatment plant before
        discharge to sewer. The alkylation liquor is then refined in a 3-column distillation
        train. Pure ethyl benzene is recovered for subsequent use in the dehydrogenation
        plant. Excess benzene and the polyethyl benzene are recovered and recycled to the
        reactors. The heavy distillation residue is utilised elsewhere in the complex to
        lower the viscosity of other residue streams and ultimately utilised as fuel.
        In the dehydrogenation plant, ethyl benzene is dehydrogenated to styrene at high
        temperature and low pressure in the presence of steam. The dehydrogenated
        mixture is condensed and cooled, the water is separated out, and the stream is
        refined in a 3-column distillation train. Hydrogen and other gases produced in the
        reactor are used as fuel. By-product benzene and toluene are recovered and sent to
        the Litol plant for conversion to pure benzene. Unreacted ethyl benzene is
        recovered and returned to the dehydrogenation reactor. Pure styrene is distilled and
        dosed with a polymerisation inhibitor prior to storage.
        Tanks containing benzene are vented to a carbon bed vapour emission control
        system that recovers about 60 t of benzene per annum and returns it to the styrene
        plant.

        Phenol manufacture

        The phenol plant was commissioned in 1968. It produces phenol and acetone in a
        continuous, fully enclosed process. Cumene is formed by the reaction of pure
        benzene and propylene in a fixed-bed reactor using a phosphoric acid catalyst on a
        solid support. The pure benzene feedstock is either imported or produced in the
        styrene plant and piped to the phenol plant. A 3-column refining section recovers
        gaseous components from the cumene stream. Unreacted benzene is recycled into
        the process, and cumene is sent on to the oxidation reactor. Heavy distillation
        residue is utilised as fuel or as an aromatic feedstock in the Litol plant. The purified
        cumene stream is partially oxidised with air to cumene hydroperoxide, which is
        cleaved by acid to a mixture of crude phenol and acetone. The mixture is split into
        phenol and acetone, which are purified by distillation in a 7-column refining train.
        Heavy distillation residue is subjected to a 2-column system, where some
        additional phenol is recovered via pyrolysis and distillation for recycling to the
        refining train. Residue from this system is utilised as fuel. Spent air from the
        oxidation reactor is chilled to remove most of the organic substances and then
        passed through activated carbon beds before release to the atmosphere. A combined
        aqueous waste stream is treated in the site effluent treatment plant prior to
        discharge to sewer.

7.2.4   Laboratory uses
        Seven of the applicants listed in Section 3 identified themselves as occasional
        importers of reagent grade benzene. Between them, they imported approximately
        500 kg benzene in 1999, which was onsold to a total of 55 end users. Of these, 27
                                                                 Priority Existing Chemical Number 21
                                              22

          were commercial enterprises such as contract and company in-house analytical
          laboratories. Twenty-one belonged to the science or medical faculties of 15
          different universities. Seven were State or Commonwealth laboratories. The
          quantities purchased by individual laboratories in 1999 ranged from 0.1-150 L
          (0.88-130 kg), with a mean of 10 L (8.8 kg) and a median of 2.5 L (2.2 kg).
          Benzene is also present in some ready-made liquid or gaseous standards for the
          calibration of gas chromatographs and other analytical instruments. The quantity of
          benzene consumed through the use of such standards is estimated at less than 1 kg
          per annum.

7.2.5     Coincidental production
          Benzene is formed coincidentally during the burning of aromatic and non-aromatic
          organic compounds contained in biomass such as crops, wood and humus, in fossil
          fuels such as black and brown coal, and in petroleum products including diesel and
          jet engine fuel which have a negligible benzene content prior to combustion. These
          processes are important sources of entry into the environment and will be
          considered in detail in subsequent sections.

7.3       Summary
          Table 7.3 summarises the industrial mass balance of benzene in Australia and the
          available information on its major manufacturers, importers and users, and most
          significant end uses. These figures are approximate and give a general indication of
          industrial use of benzene in Australia. Benzene produced coincidentally in the
          course of human activities or natural processes and products containing benzene as
          an impurity are not accounted for.

          Table 7.3: Benzene mass balance and major manufacturers, importers and
          end users in Australia in 1998-99

                                         Kilotonnes/year (rounded)
          Industry or   Extrac-    Manu-                                    Con-
          company                                                                    End use
                                            Import      Total    Export
                         tion     facture                                 sumption
          Petroleum       30       385        25         440         -      440      Petrol
          Huntsman         -         -        80         80          -       95      Feedstock
          Steel           15         -         -         15          -      0.2      Fuel
          Qenos            -        15         -         15          15    0.040     Solvent
          Others           -         -      0.0005      0.0005       -     0.0005    Reagent
          TOTAL           45       400       105         550         15     535      -


          In 1998-99, total benzene consumption in Australia was in the order of 535 kt per
          year. Of this quantity, 105 kt were imported, 45 kt were extracted from crude oil
          and coal gas, and the remainder produced at eight oil refineries. Petrol accounted
          for approximately 82%, chemical synthesis for 18% and all other uses combined
          for less than 1% of total consumption.




Benzene                                            23

        8. Environmental Release, Fate
           and Effects

        As no environmental fate and toxicity studies were submitted for assessment, this
        section is based on international, peer-reviewed reports such as GDCh (1988),
        Government of Canada (1993) and IPCS (1993), the International Uniform
        Chemical Information Database (IUCLID) and the USEPA's ECOTOX database
        (USEPA, 2000). Data within these three reports are largely the same and also
        appear in the databases.
        IUCLID contains non-confidential data supplied by industry to the European
        Commission. They have not undergone peer review and are therefore only reported
        where they are not described elsewhere but nonetheless give guidance to the fate
        and effects of benzene in the environment. Results in the ECOTOX database have
        been published and are generally considered reliable.

8.1     Environmental release
        Benzene is ubiquitous in the environment, with numerous sources of entry
        including bush fires, crop residue and forest management burning, petrol
        combustion, wood fires, tobacco smoking and emissions and waste streams from
        various industries. Due to the nature of benzene being produced incidentally during
        natural processes and human activities, it is not possible to obtain accurate figures
        in estimating national releases. However, several point source releases provided in
        NPI reports for the first reporting year of 1998/99 are described in Section 15,
        which also gives an estimation of diffuse releases in a model urban environment.
        Overall, release of benzene will primarily be to the atmosphere through emissions
        in exhaust during petrol combustion in motor vehicles, followed by releases to air
        from point sources in the petroleum, steel, aluminium, chemical and other
        industries. By contrast, releases to water and soil are expected to be relatively
        minor, as borne out in NPI reports where the highest annual release from a single
        point source to water and soil was 1100 kg and 45 kg respectively, compared with
        130,000 kg to air from an oil and gas extraction plant.

8.2     Environmental fate
        The Trent University (1999) Level 1 Fugacity Based Environmental Equilibrium
        Model indicates that in the order of 99% of benzene will partition to air, with
        0.88% and 0.05% partitioning to water and soil respectively. Negligible amounts
        are expected to partition to sediments, suspended sediments, biota and aerosols.

8.2.1   Atmospheric fate
        The water solubility of benzene suggests that one removal mechanism from the
        atmosphere is through returning to the terrestrial and aquatic compartments in
        rainwater. However, the Henry's Law constant and volatility of benzene indicate
        that the chemical would rapidly volatilise back into the atmosphere where it would
        be available for abiotic breakdown.


                                                               Priority Existing Chemical Number 21
                                             24

          Direct photolysis

          IPCS (1993) reports that direct photolysis of benzene in the troposphere is unlikely
          since the UV-visible spectrum of benzene shows no appreciable absorbance at
          wavelengths >260 nm. According to GDCh (1988), direct photolysis is of minor
          importance for the same reason.
          IUCLID provides test results for a smog chamber experiment in which light with a
          wavelength >290 nm corresponding to tropospheric sunlight was used with
          benzene at a concentration of 100 ppm (0.32 mg/L). Although the validity of this
          test cannot be judged due to insufficient documentation, the outcome showed no
          evidence of benzene degradation. After the addition of chemicals producing active
          species, benzene half-lives were between 4-5 h. Using light with a higher intensity
          (wavelengths >230 nm), a half-life of 6.5 h was detected. These findings indicate
          that direct photolysis is minimal at environmentally significant wavelengths, stated
          by Howard et al. (1991) to be >290 nm, and thus confirm that this process will not
          be a major removal process for benzene in the troposphere.

          Indirect photolysis

          IUCLID provides details for several studies on indirect photolysis. The results of
          those where a half-life was determined are presented in Table 8.1. In all tests,
          hydroxyl radicals were used as the reactant, with air as the medium. Not all studies
          had temperature reported. However, where available, it was 25ºC. While the
          validity of these studies is uncertain, it is well accepted that indirect photolysis
          through reaction with hydroxyl radicals is the major degradation pathway for
          benzene in air (GDCh, 1988; Government of Canada, 1993; IPCS, 1993).

          Table 8.1: Half-life of benzene in the atmosphere where degraded by hydroxyl
          radicals

                             Hydroxyl concentration              Rate constant
                                             3                    3
          Light source           (radicals/cm )                (cm /(molecule.s)           Half-life (days)
                                                5                              -12
          Sun light                    5 x 10                       1.2 x 10                     13.4
                                                5                              -12
          Other*                       5 x 10                       1.2 x 10                     13.4
                                                    6                          -12
                                                                    1.3 x 10                      19
          Sun light                   7.5 x 10
                                                    6                          -12
          Sun light                   1.1 x 10                      1.3 x 10                      5.6
                                                    6                            -12
                                                                  1.2-1.6 x 10                    5.3
          Sun light                   1.2 x 10

          * Hydroxyl radicals produced by flash photolysis and using a resonance fluorescence method.

          The Dutch Environment Ministry calculated a half-life of benzene in the
          atmosphere of 5.3 days assuming an average hydroxyl radical concentration of 1.25
          x 106 molecules/cm3 over the Netherlands with a rate constant of 1.3 x 10-12
          cm3/(molecule.s). This is reported in both IPCS (1993) and GDCh (1988), although
          neither report describes the basis for the assumed hydroxyl radical concentration.
          The global 24-h average hydroxyl radical concentration has been reported to be
          around 5 x 105 molecules/cm3 (Calamari, 1993; GDCh, 1988). Additionally, using
          the OECD Environment Monograph No. 61 (OECD, 1993), a rate constant for
          benzene can be calculated at 2 x 10-12 cm3/(molecule.s) (contrary to the range of
          0.8-1.4 x 10-12 cm3/(molecule.s) quoted in GDCh (1988)). Applying the global
          average hydroxyl radical concentration and rate constant from the OECD
          monograph and following the methodology in this monograph, gives an estimated
          half-life of 8 days. This is more in agreement with the Canadian authorities where a
          half-life attributable to reactions with hydroxyl radicals was calculated to be 9 days

Benzene                                                 25

under typical urban atmospheric conditions, although the hydroxyl radical
concentration and rate constant were not reported (Government of Canada, 1993).
The global concentration used above applies to the average for the whole
troposphere. In the lower troposphere where benzene and hydroxyl radicals occur
at higher concentrations, the benzene half-life would be expected to be lower, and
is reported as 3-10 days (GDCh, 1988). Additionally, in districts with high traffic
density, where there is a higher concentration of hydroxyl radicals because of
higher concentrations of precursors, a lower atmospheric half-life can be expected,
and again 3-10 days is reported (GDCh, 1988).
For the purposes of this assessment, an atmospheric half-life of 8 days will be used
based on the globally accepted tropospheric average for the concentration of
hydroxyl radicals and the methodology and rate constant prescribed in the OECD
monograph.
These results given above are all within the range predicted in Howard et al. (1991)
where the photooxidation half-life in air has been calculated to fall between 50.1 h
(2.09 days) and 501 h (20.9 days).
The proposed degradation pathway through reaction with hydroxyl radicals is
shown in Figure 8.1 (Verscheuren, 1996).
Figure 8.1: Proposed degradation pathway of benzene in the atmosphere


                                        OH




                                                  HO2
                    + HO


                                                                         O
                                   O2
                                                  NO                         HO2
                                        O
                             O
                                                            O

                                                                  glyoxal
                                                  NO2
                                  O2
                                                                     +
                                             OH
                                 Endoperoxide           O
                                                                                O

                                                                butenedial



In the IUCLID database one study is described where ozone was used as a reactant.
In this test, air was the medium and the light source was chemiluminescence. A
sensitiser concentration of 3 x 1012 molecules/cm3 and a rate constant of 1 x 10-22
cm3/(molecule.s) were used. In an urban atmosphere, the half-life for the reaction
of benzene with ozone was calculated to be 105 years. In a rural atmosphere, the
half-life would be 327 years, using an atmospheric concentration for ozone of 9.6 x
1011 molecules/cm3. Therefore, photolysis through reaction with ozone is not
expected to be a major removal process for benzene in the atmosphere.
One test is described where atomic oxygen was used as the reactant at a
concentration of 7.2 x 104 molecules/cm3 with a rate constant of 2.8 x 10-14
cm3/(molecule.s). The half-life for this reaction between benzene and atomic


                                                            Priority Existing Chemical Number 21
                                        26

          oxygen was calculated to be 10.9 years, indicating that this reaction will not be a
          major removal process of benzene from the atmosphere.
          One test describes the photodegradation using sulphur dioxide as the reactant. The
          test was performed in air with sunlight as the light source (light spectrum >290
          nm). Benzene was present at a concentration of 100 ppm (0.32 mg/L). No further
          information is available on the method, so the validity of this test is unknown.
          However, sulphur dioxide was present at a concentration of 10-110 ppm (0.026-
          0.288 mg/L). Photodegradation was observed. IUCLID states that approximately 2
          days was required for 50% degradation to CO2, although the half-life for
          photodegradation of benzene is stated as 6 h.

8.2.2     Aquatic fate

          Photolysis in water

          Direct photolysis of benzene in aqueous solution was investigated with half-lives
          observed varying from 9-673 days. However, the authors concluded that the test
          method was not suitable for poorly soluble, volatile substances (GDCh, 1988).
          Two direct photolysis studies are reported in IUCLID where benzene was tested
          adsorbed on silica gel. In both tests the concentration of benzene was 0.32 mg/L
          and the light source was not stated. Few details are reported and the validity of the
          tests is unknown. However, one was irradiated at >230 nm (not environmentally
          significant), and resulted in a half-life of 6.5 h. The other was irradiated at
          tropospheric wavelengths (>290 nm) and showed that 5% had photomineralised to
          CO2 after 17 h.

          Hydrolysis

          IUCLID provides two reports for abiotic degradation of benzene, both concluding
          that hydrolysis is not expected to be a significant process for removing benzene.
          Few details are available for these tests and validity cannot be assumed. However,
          degradation by this route is not expected, as benzene has no hydrolysable groups.

          Volatilisation

          Volatility from water to air is summarised in several reports in IUCLID.
          Based on a reported Henry's Law constant of 0.0053 atm.m3/mol and a model river
          1 m deep flowing at 1 m/s with a wind velocity of 3 m/s, the half-life of benzene
          was 2.7 h at 20°C.
          The half-life for the evaporation of benzene from seawater was investigated in a
          mesocosm containing planktonic and microbial communities. Half lives for
          summer, spring and winter were reported as 3.1, 23 and 13 days respectively.
          The half-life for evaporation of benzene from a 1 m thick still water column was
          4.8 and 5 h at 25 and 10°C respectively by thermodynamic calculations. The
          residence half-time for well-mixed water was 37 min. This half-life of 4.8 h is also
          included in the IPCS (1993) and Government of Canada (1993) reports.
          An experiment in a wind-wave tank 6 m long, 0.61 m deep and 0.6 m wide with
          wind velocities of around 6-13 m/s at a temperature of 20.7°C is described. The
          testing period was >50 h so that an approximate 10-fold change of solute
          concentration (which was measured by gas chromatography) would occur. The

Benzene                                        27

        mass transfer coefficients of benzene at the water-air interface were 11.4-34 cm/h
        dependent on wind velocity. The volatilisation is of first order kinetics. For a wind
        speed of 7.09 m/s, a half-life of 5.2 h can be calculated.
        While the reliability of these results is unclear, they support that rapid volatilisation
        from water will occur.

8.2.3   Terrestrial fate

        Adsorption

        Documentation on the adsorption of benzene to soil is limited as the exposure of
        the terrestrial compartment is likely to be low.
        The Government of Canada (1993) report cites Koc values for benzene ranging
        from 12-213, indicating the chemical to be moderately to highly mobile in soil.
        IUCLID reports a calculated soil absorption coefficient of 71, using equations
        developed by Kenaga & Goring and published by the American Society for Testing
        and Materials. While this reference has not been obtained, an experimental soil
        absorption coefficient value of 83 is reported in IUCLID as well as in IPCS (1993).
        IPCS (1993) cites a rounded log Koc range of 1.8-1.9 (Koc = 60-83), indicating fair
        mobility in soil, and states that benzene is not expected to adsorb to bottom
        sediments based on its Koc, solubility and volatility.
        Koc values provided in IUCLID indicate that benzene may exhibit high mobility in
        soils and may migrate to groundwater. Several tests are reported and are generally
        described as valid, or valid with restrictions. They can be used to provide a guide as
        to the adsorptive behaviour of benzene.
        One report gave the results of adsorption tests using radioactive labelled test
        substance on aquifer material. This test is described as valid with IUCLID noting
        that the test procedure was in accordance with generally accepted scientific
        standards and described in sufficient detail. The results provided log Koc values
        between 2.09 and 3.01 (Koc 123-1023). Experiments were carried out in capped
        glass centrifuge tubes on two American groundwater aquifer materials with the
        following characteristics:
            Material: Sand (%):           Silt        Clay       Organic matter            pH:
                                         (%):         (%):           (%):
                A            90           8.0          2.0            4.4                  3.8
                B           70.4         24.0          5.6            2.2                  5.5
        Both these materials were acidic, with material A being quite acidic. It cannot be
        concluded from the IUCLID summary whether Koc was a function of pH, although
        this is not expected to be the case since benzene is a neutral molecule. These results
        suggest that benzene is moderately mobile.
        A water-soil adsorption coefficient of 18.2 provided in IUCLID was measured in
        soil-solution mixtures which were equilibrated for 24 h at 20°C in capped
        centrifuge tubes. Losses by volatilisation were avoided by sampling through the
        septum of the caps. The substance amounts were corrected by the airspace of the
        tubes under consideration of air volume and Henry's Law constant. Soil
        characteristics were reported as 9% sand; 68% silt; 21% clay and 1.9% organic
        matter. pH was not stated.

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          While IUCLID also provides some calculated results, these are not reported here as
          measured values are considered more reliable and the terrestrial compartment is not
          expected to be a significant sink for benzene.

          Volatilisation

          The primary mechanisms responsible for loss of benzene from soil are
          volatilisation to the atmosphere and runoff to surface water. Benzene released
          below the soil surface may leach to groundwater (Government of Canada, 1993).
          The volatility of benzene from soil to air is summarised in two reports in IUCLID.
          In one report, the half-lives of volatilisation, without water evaporation, of benzene
          uniformly distributed at a rate of 1 kg/ha to 1 and 10 cm in soil with an organic
          carbon content of 1.25% were 7.2 and 38.4 days respectively. The second report is
          from a model developed to predict the environmental fate of benzene following
          leakage of gasoline from an underground storage tank. It estimated that some 67%
          of the benzene would volatilise from the soil within 17 months, with 29% leaching
          to groundwater and the remainder associating with the soil.

8.2.4     Biodegradation
          IPCS (1993) provides the following insight into the biodegradation of benzene:
              In surface and ground water benzene is biodegradable by microorganisms
          ·
              under both aerobic and anaerobic conditions with the mechanism of
              biodegradation seeming to involve the formation of catechol via cis-1,2-
              dihydroxy-1,2-dihydrobenzene followed by ring cleavage.
              One study on the aerobic biodegradation of benzene in groundwater utilised a
          ·
              mixed bacterial culture from groundwater and soil bacteria capable of using
              gasoline as a sole carbon source. Under closed agitated conditions without
              added nutrients the half-life appeared to be <48 h with benzene levels falling
              from 480 to 218 µg/L in this time. When ammonium nitrate was added, the
              reaction was much faster, with benzene levels decreasing to 35 µg/L in 20 h.
              The biodegradation of benzene in ground and river waters appears to follow
          ·
              first-order rate kinetics with reported half-lives of 28 and 16 days respectively.
          IUCLID provides results from several biodegradation studies which generally agree
          that a significant degree of biodegradation occurs under aerobic conditions. Some
          tests classify the substance as readily biodegradable. However, many of the tests
          are not ready biodegradation tests and the results do not indicate degradation that
          would be fast enough for benzene to be classed as readily biodegradable. While
          validity cannot be assumed, they may be used to provide guidance as to the
          biodegradability of benzene. As such, for the purposes of this assessment, the
          chemical will be considered at least inherently biodegradable.
          The majority of tests summarised in IUCLID for anaerobic degradation indicate
          degradation is very slow to non-existent. This is supported in the GDCh (1988)
          report where it is stated that degradation of benzene has not yet been detected in
          anaerobic conditions. However, IPCS (1993) describes a report where samples of
          landfill leachate incubated under methogenic conditions in an anaerobic glove box
          showed a 72% reduction in benzene concentrations after 40 weeks, although no
          significant benzene biodegradation occurred during the first 20 weeks of
          incubation. In another study using anaerobic digesting sludge under methano-
          trophic conditions, benzene was undegraded after 11 weeks. It is also reported that

Benzene                                        29

        no toxic effects of benzene on the anaerobic digestion of sewage sludges were
        observed until levels of 50-200 mg/L had been reached.

8.2.5   Bioaccumulation
        Benzene is not expected to bioconcentrate to any significant degree in aquatic or
        terrestrial organisms given the reported values for log Po/w of 1.56-2.15 (GDCh,
        1988; ICPS, 1993). IPCS (1993) also reports a bioconcentration factor (BCF) for
        freshwater algae of 30, for water fleas of 153-225 depending on the concentration
        of benzene in their food, and for goldfish of 4.3.
        GDCh (1988) reports measured BCF values in Clupea harengus (herring) of 2-6 in
        most organs, and 31 in the gall bladder. One study outlined in this document claims
        no significant biological accumulation in algae or fish. For fish, the BCF was in the
        range of 1-10 after 3 days.
        These conclusions are largely supported by data available from USEPA (2000) and
        IUCLID. Results are available for several species of fish including Anguilla
        japonica (Japanese eel), Leuciscus idus melanotus (golden orfe), Morone saxatilis
        (striped bass), Salmo gairdneri (rainbow trout) and Engraulis mordax (Northern
        anchovy). BCF values were all under 100, with the exception of the Northern
        anchovy. This species provided BCF values of 113-505, with an outlying result of
        8450. There is not enough detail to determine whether these factors are for specific
        organs or the whole organism, which would impact on the analysis.
        Nonetheless, based on the scale provided in Mensink et al. (1995), benzene can be
        classed as slightly to moderately concentrating in fish. No data are available on
        depuration rates.
        Benzene appears to be more concentrating in invertebrates with results generally
        indicative of a moderately concentrating chemical. Several species of invertebrates
        have test results reported by USEPA (2000). An 8-day static and 9-day flow
        through test on Brachionus plicatilis (rotifer) showed BCF values of 100-1000
        under static conditions and 10,000 under flow through conditions. The maximum
        concentration tested was 900 µg/L, well within the limit of solubility. Three results
        are available for Daphnia pulex with BCF values ranging from 153-225.
        Several results in IUCLID were also reported by USEPA and have not been
        duplicated here. IUCLID provides information on depuration from Daphnia pulex.
        Daphnids were exposed to water dosed with 10 µg/L benzene, water containing
        algae preloaded by incubation with 50 µg/L benzene, or both dosed water and
        preloaded algae. The reported BCF values were 225 for exposure to just dosed
        water, 203 for feeding on preloaded algae and 153 after incubation in dosed water
        with preloaded algae. Where exposure was through dosed water only, clearance
        was 88% after 72 h. Where daphnids were exposed to dosed water and preloaded
        algae, 83% clearance was reported when moved to fresh water with unloaded algae,
        although the time involved in this depuration was not stated.
        Limited data are available for algae, but suggest bioaccumulation will be slight,
        with the ECOTOX database (USEPA, 2000) reporting BCF values of 30 for the
        green algae Chlorella fusca and Chlorella fusca vacuolata.




                                                               Priority Existing Chemical Number 21
                                             30

8.3       Effects on organisms in the environment
          Of the three assessments listed at the beginning of this section, only GDCh (1988)
          has any detailed discussion of the effects of benzene on organisms in the
          environment. As this publication is relatively old, the USEPA's ECOTOX database
          was interrogated for more recent results (USEPA, 2000). In addition, IUCLID was
          consulted where limited data were reported in the other two sources, but as this is
          largely unvalidated, is used for guidance only. Not all available information is
          reported here due to its volume. However, the range for each trophic level will be
          given with an indication of where the majority of results fall.

8.3.1     Aquatic organisms

          Fish

          The majority of reported results come from tests performed under static conditions.
          GDCh (1988) provides 96-h results for 7 freshwater species including Leuciscus
          idus melanotus (golden orfe), Lepomis macrochirus (sun perch), Pimephales
          promelas (fathead minnow), Lebistes reticulatus (guppy), Carassius auratus
          (goldfish), Gambusia affinis (mosquito fish) and Ictalurus punctatus (channel
          catfish), with LC50 values ranging from 15-430 mg/L. Most of these fall in the 10-
          100 mg/L range, indicating slight toxicity to fish. This is largely supported by more
          recent data from USEPA (2000) where a 48-h LC50 to Mugil curema (white mullet)
          of 22 mg/L, 96-h LC50 to fathead minnow of 12.6-24.6 mg/L and 96-h LC50 to
          Poecilia reticulata (guppy) of 28.6 are reported. These results are all indicative of
          slight toxicity.
          Flow through tests provide more sensitive results. All flow through results are for
          rainbow trout. Two tests reported in GDCh (1988) give 96-h LC50 values of 5.3 and
          9.2 mg/L, while one more recent result gives a 96-h LC50 of 5.9 mg/L (USEPA,
          2000). These results are indicative of moderate toxicity.
          GDCh (1988) reports a 96-h LC50 of 5.8 mg/L in the saltwater species Morone
          saxatilis (striped bass), which is indicative of moderate toxicity. The test conditions
          are not known.
          As such, benzene can be considered moderately to slightly toxic to fish under acute
          exposure.
          Chronic and sub-chronic data for fish appear limited with only one study reported
          in GDCh (1988). Following 14 days exposure of Lebistes reticulatus (guppy) under
          static conditions, a LC50 of 63 mg/L was determined.
          The Government of Canada (1993) report highlights an investigation into the
          chronic toxicity of benzene to the early life stages of rainbow trout, leopard frog
          and the Northeastern salamander. Eggs of each species were exposed continuously
          to benzene from within 30 minutes of fertilisation (embryos) through to 4 days
          post-hatch (larvae). This resulted in continuous exposures of 27 days for rainbow
          trout, 9 days for leopard frog and 9.5 days for Northeastern salamander. The
          corresponding LC50 values were 8.3, 3.7 and 5.2 mg/L respectively.
          IUCLID provides results of tests in Pimephales promelas (fathead minnow),
          Morone saxatilis (striped bass) and Clupea harengus (pacific herring) for 7-day,
          28-day and 17-day exposure periods respectively. The striped bass was exposed
          under flow through conditions. A no observed effect concentration (NOEC) of
          10.2, 3.1 and 0.49-0.88 mg/L was reported for fathead minnow, striped bass and
Benzene                                        31

pacific herring respectively, although those for pacific herring were the highest
concentrations tested on these fish so no real conclusions can be drawn from the
results.
Overall, these results indicate that benzene is of very low toxicity to fish from
chronic exposure.
GDCh (1988) lists some toxic effects of benzene on developmental stages and
behaviour of fish. Pacific herring demonstrated a decrease of survival time of eggs
after 48-h exposure of sexually mature females at 0.7 mg/L. However, this study
was conducted in a polluted region so other chemicals may have been responsible.
Other tests on pacific herring showed unspecified developmental abnormalities at
31-40 mg/L. Also, 24-h exposure of embryos to sublethal concentrations (up to
1.85 mg/L) under static conditions showed an effect on metabolism. Significantly
less growth of the embryos, altered oxygen consumption and greater food intake in
larvae were reported.
Sublethal effects were reported in the coho salmon at 1.8 mg/L and an increase in
the respiratory rate of chinook salmon was found at 4.4 mg/L. This effect was also
observed at the same concentration in striped bass.

Invertebrates

Invertebrates appear to be the largest group tested. GDCh (1988) provides results
for four freshwater species, of which Daphnia magna, Daphnia pulex and Daphnia
cucullata all had 48-h EC50 values >100 mg/L. One freshwater invertebrate, Aedes
aegypti (mosquito larva) had a 24-h LC50 of 59 mg/L. Of the saltwater species
reported in GDCh (1988), benzene could be considered moderately toxic to four
species: Artemia salina (salt water shrimp), Crango franciscorum (bay shrimp),
Nitroca spinepes and Palaemonetes pugio (grass shrimp), with 24- to 96-h LC50
values ranging from 20-82 mg/L. Two salt water species, Cancer magister
(Dungeness crab) and Crassostrea gigas (oyster), had 96-h LC50 values >100 mg/L.
More recently published data from the ECOTOX database (USEPA, 2000) largely
confirm the moderate to slight toxicity of benzene to aquatic invertebrates outlined
above. Moderate toxicity is reported for Ceriodaphnia dubia (water flea; 24-h EC50
= 18.4 mg/L), Gammarus fossarum (scud; 96-h LC50 = 53 mg/L) and Corixa
punctata (water boatman; 48-h LC50 = 48 mg/L), with LC50 values >100 mg/L
reported for a further three species: Daphnia magna, Lymnaea stagnalis (great
pond snail) and Viviparus bengalensis (snail).
However, one crab species (Scylla serrata) was relatively sensitive to benzene,
with three 96-h LC50 results (mortality as the end point) of 3.7, 6.1 and 7.7 mg/L.
While the majority of results indicate benzene is only moderately to slightly toxic
to aquatic invertebrates, this species shows benzene may be considered toxic to
some aquatic invertebrates.
GDCh (1988) only describes one study where chronic effects were investigated in
Daphnia magna. In a lifetime and partial lifetime test, no toxic effect of benzene
was found at a concentration of 98 mg/L.
Only one chronic test is available in IUCLID where sufficient detail is presented.
This test on a crab species (Cancer magister) indicates slight toxicity to aquatic
invertebrates. Larval stages of the crab were continuously exposed after hatching in
a flowing water laboratory culture system at benzene levels of 0.17-0.18, 1.1-1.2
and 6.5-7.0 mg/L. Benzene had little effect on the duration of the larval stages and

                                                       Priority Existing Chemical Number 21
                                    32

          no effect on the size of surviving larvae. At the lowest concentration, there was no
          effect on survival. At the other two concentrations, benzene led to an accelerated
          mortality rate compared to untreated controls. After 10 days of exposure at the
          highest concentration, most larvae died. At the middle concentration, most larvae
          died before day 20 of exposure. Therefore, the 20-day NOEC was 0.17 mg/L.

          Algae

          Data covered in GDCh (1988) suggest benzene is only slightly to very slightly
          toxic to algae. A 24-h EC50 on the green algae (Chlorella vulgaris) based on cell
          division was >>100 mg/L.
          Three 72-h EC50 values are reported for sea algae with cell division as the end
          point. The green algae (Dunaliella tertiolecta), siliceous algae (Skeletonema
          costratum) and yellow-green algae (Cricopshaera carterae) all had EC50 results
          >100 mg/L. In a 3-day test in the dinoflagellata Amphidinium carterae, the EC50
          with cell division as the end point was reported to be 50 mg/L, indicating slight
          toxicity (GDCh, 1988).
          More recent data from the ECOTOX database (USEPA, 2000) appear more
          indicative of slight toxicity than the earlier studies reported in GDCh (1988). One
          72-h EC50 in Selanastrum capricornutum of 29 mg/L and a 24-h EC50 for the
          diatom Thalassiosira pseudonana of 40 mg/L are reported.
          In summary, benzene can be classed as slightly to very slightly toxic to algae under
          acute exposure.
          In 8-day tests, >1400 mg/L benzene had no detectable effect on biomass in the
          freshwater species Scenedesmus quadricauda and the blue alga Microcystis
          aeruginosa (GDCh, 1988). With growth as the end point, the more sensitive
          species Selenastrum capricornutum provided an 8-day EC50 of 41 mg/L, although a
          14-day EC50 of 292 mg/L is also reported for this species (USEPA, 2000).

          Predicted No-Effect Concentration (PNEC) in the aquatic environment

          As there are results available for both acute and chronic exposure in three trophic
          levels, the lowest NOEC for chronic exposure, in this case to the aquatic
          invertebrate crab species Cancer magister, will be used with an assessment factor
          of 10. While this result (NOEC = 0.17 mg/L) is based on unvalidated results from
          IUCLID, it is considered that there are sufficient data available from published and
          peer-reviewed sources for this test to be accepted for use in a worst-case PNEC and
          that there is sufficient detail in the IUCLID report to support the results.
          Therefore, the PNEC for the aquatic environment is 0.17/10 = 0.017 mg/L, or 17
          µg/L.

8.3.2     Terrestrial organisms
          A study in Eisenia fetida (earthworm) is reported in the ECOTOX database
          (USEPA, 2000), in which an LC50 of 98 µg/cm2 was determined in adult worms
          weighing 300-500 mg placed for 48 h on filter paper impregnated with a solution of
          benzene in water, acetone and trichloromethane.
          According to GDCh (1988), use of benzene as a solvent for plant protection agents
          in bioassay tests showed that it is slightly toxic to various insect species. The LD50
          for the house fly (Musca domestica) was 0.8 mg per animal. Exposure to benzene

Benzene                                        33

      in the vapour phase exhibited toxic action in the grain weevil (Calandra granaria),
      although the concentration is not reported. Benzene acted as a repellent to the
      adults of certain species of flies (Diptera).
      In plants, air concentrations >50 mg/m3 (>15.5 ppm) have a lethal effect. However,
      all plant species investigated recovered from sublethal effects. In water, higher
      concentrations of 0.9-1.3 g/L have a growth-inhibiting effect (GDCh, 1988).
      It is difficult to translate the earthworm measurement to an application rate likely to
      lead to adverse impacts in soil and a PNEC cannot be determined from these data.

8.4   Summary
      Benzene is expected to partition predominantly to the atmosphere, with the primary
      route of degradation coming from indirect photolysis through reaction with
      hydroxyl radicals. Direct photolysis or reactions with oxygen or ozone are not
      expected to be major removal processes from the atmosphere. Based on the
      accepted global concentration of hydroxyl radicals, the degradation half-life of
      benzene from the atmosphere is calculated at 8 days.
      Benzene is largely abiotically stable in water, with the major removal process
      expected to be volatilisation. The high water solubility and relatively low log Po/w
      indicate that benzene will not adsorb significantly to organic matter and sediments.
      When released to the terrestrial compartment, benzene may be relatively mobile
      and may leach to groundwater if released underground, for example, from leaking
      storage tanks. The chemical is unlikely to adsorb readily to soils and may readily
      volatilise from soil surfaces.
      Benzene may be considered biodegradable under aerobic conditions, although
      under anaerobic conditions, biodegradation may be expected to be very slow.
      Based on the chemical's low log Pow and experimental results, bioaccumulation is
      not expected to any significant degree, and at worst, benzene can be described as
      moderately concentrating.
      Aquatic organisms exhibit only a low level of sensitivity to benzene, with the
      chemical being slightly toxic to fish following acute exposure under static
      conditions and moderately toxic under flow through conditions. Chronic exposure
      of fish to benzene gave results indicative of slight toxicity. Invertebrates appear to
      be the largest group of aquatic organisms tested. For the majority of species tested,
      benzene was only slightly to very slightly toxic. However, one crab species was
      relatively sensitive, with results in the range of a moderately toxic chemical.
      Chronic results show benzene to be slightly toxic to aquatic invertebrates. Benzene
      may also be classified as slightly to very slightly toxic to algae. The PNEC for the
      aquatic environment is 17 µg/L.
      Limited data on the toxicity of benzene to terrestrial organisms show the chemical
      to be slightly toxic to various insect species and the earthworm. In plants, high
      concentrations in air have a lethal effect, although all plants investigated recovered
      from sublethal effects.




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          9. Kinetics and Metabolism

          The toxicokinetics and metabolism of benzene have been extensively investigated
          in several animal species and, to a lesser extent, in humans. Studies relevant to the
          toxicokinetics of benzene have been reviewed and summarised in this section. The
          metabolites and their modes of action are further discussed in Section 12. A
          number of reviews of benzene toxicokinetics and metabolism are available,
          including IPCS (1993) and ATSDR (1997).

9.1       Absorption

9.1.1     Animal studies

          Inhalation

          Schrenk et al. (1941) found the absorption of benzene vapour by dogs after
          inhalation exposure to be rapid. Inhalation of the vapour (800 ppm) over 4-7 h
          resulted in the concentration of benzene in arterial blood approaching equilibrium
          conditions by 30 minutes. Although considerable inter-animal variation was noted,
          a linear relationship was demonstrated between the concentration of benzene in air
          over the range from 200-1300 ppm and the equilibrium concentration in blood. In
          another study, the absorbed dose after inhalation (nose-only) of [14C]-benzene
          (approximately 10-1000 ppm) for 6 h by rats (F344) and mice (B6C3F1) was found
          to be non-linear. The percentage of benzene absorbed decreased from 33% to 15%
          in rats and from 50% to 10% in mice as the exposure concentration increased from
          10 to 1000 ppm. Due to apparent physiological differences in respiration between
          the two species, mice inhaled approximately twice the amount of benzene
          compared to rats (Sabourin et al, 1987). Similarly, Eutermoser et al. (1986) found
          that the absorption rate of benzene vapour (300 ppm) by male rats (Sprague-
          Dawley) decreased with increasing duration of exposure. When determined after 1,
          3 and 6 h of continuous exposure and compared to baseline values, benzene
          absorption decreased to 33, 22 and 9% respectively. Male mice (Swiss) when
          exposed to benzene (310 ppm) for 1, 3 and 6 h of continuous exposure and
          compared to baseline values gave values of 65, 76 and 81% respectively. Thus after
          the first hour, the rate of benzene uptake by rats decreased significantly compared
          to mice.

          Dermal

          Dermal absorption of liquid benzene was investigated by Maibach & Anjo (1981)
          using intact and abraded skin of rhesus monkeys. Under conditions where
          evaporative losses were allowed, the application of a single dose of benzene to
          intact skin resulted in absorption of 0.17% of the dose while the application of
          multiple doses (11 exposures with an interval of 15 min) resulted in 0.85% of the
          dose being absorbed. In contrast, abraded skin resulted in 0.91% of the applied
          dose being absorbed. Similar results were obtained by Franz (1984) who found that
          after a single dermal application of benzene, 0.14% and 0.09% was absorbed by
          rhesus monkeys and miniature pigs respectively. It was concluded from the in vitro
          studies that the major factor influencing percutaneous absorption of benzene was its
          contact time with the skin. Susten et al. (1985) reported similar findings with

Benzene                                        35

        hairless mice (HRS/J) using a skin chamber where less than 1% of the applied dose
        was absorbed.
        Adsorption of benzene onto soil matrices (sandy or clay soil) was found to modify
        the dermal absorption of [14C]-benzene when applied topically to male rats
        (Sprague-Dawley) over a 72-h period using a glass skin chamber. While the peak
        plasma level of radioactivity after exposure to benzene adsorbed onto sandy soil
        was comparable to that obtained for pure benzene, a statistically significant lower
        plasma level was obtained for benzene adsorbed onto clay, however, neither soil
        type altered the time to reach peak plasma levels which was 12 h (Skowronski et al,
        1988).
        Dermal absorption of benzene vapour has also been addressed. Dermal absorption
        (whole-body) of benzene vapour over 2, 4 or 6 h was investigated by the use of
        male nude mice attached to respirators. The dermal absorption rates for exposures
        of 200, 1000 and 3000 ppm were 4.11, 24.2 and 75.5 nmol/cm2/h (0.3, 1.9 and 5.9
        µg/cm2/h) respectively, demonstrating a linear relationship between the two
        parameters. Dermal absorption was also found to be linear with respect to exposure
        time. The dermal absorption coefficient for the mouse was determined to be 0.619
        cm/h (Tsuruta, 1989). McDougal et al. (1990) exposed male rats (F344; whole-
        body) to benzene vapour (40,000 ppm) for periods up to 4 h. The rats were shaved
        of all fur prior to exposure and provided with latex face masks attached to a fresh
        air supply during exposure. Benzene blood levels at 0.5 h were 8 µg/mL and rose to
        11 µg/mL at 4 h indicating that benzene is rapidly absorbed by the dermal route.
        The dermal absorption rate was determined to be 0.0191 mg/cm2/h and the dermal
        absorption coefficient 0.152 cm/h.

        Oral

        Following the administration by gavage of [14C]-benzene (340-500 mg/kg) to
        rabbits, approximately 80% of the ingested radiolabel was recovered in exhaled
        breath and urine indicating substantial gastrointestinal absorption at these dose
        levels (Parke & Wiliams, 1953). Similar results were obtained by the
        administration of lower doses of [14C]-benzene (0.5-150 mg/kg) to rats (F344 and
        Sprague-Dawley) and mice (B6C3F1) where it was determined that >97% of the
        dose was absorbed (Sabourin et al, 1987).

9.1.2   Human studies

        Inhalation

        In a study of 23 subjects exposed to benzene vapour (47-110 ppm) over 2-3 h,
        maximal absorption (70-80% of dose) occurred within 5 min of initial exposure.
        Subsequent absorption declined rapidly and reached a plateau at 15 min.
        Absorption remained constant for the remainder of the exposure duration at
        approximately 50% (range: 20-60%) of the exposure dose (Srbova, et al, 1950).
        Comparable results have been obtained in a number of other studies. Nomiyama &
        Nomiyama (1974a) exposed 6 volunteers (3 males and 3 females) to benzene
        vapour (52 to 62 ppm) for 4 h and showed that after an initially high absorption rate
        (50-60%), the rate decreased to reach a plateau of approximately 30-40% after 3 h
        of exposure. The mean retention of benzene, after allowances for respiratory
        excretion, was determined to be 30.2% for a 3-h exposure. Similarly, Snyder et al.
        (1981) demonstrated that during continuous exposure to benzene vapour
        approximately 50% of the dose is absorbed by the lungs. Pekari et al. (1992)

                                                               Priority Existing Chemical Number 21
                                             36

          exposed 3 non-smoking volunteers to benzene vapour (1.6-9.4 ppm) for 4 h. The
          absorbed dose was estimated to be 52% and 48% for the low and high dose
          exposure respectively based on the average difference in concentration between the
          inhaled and exhaled air.
          Further evidence for the absorption of benzene by inhalation is provided by studies
          of cigarette smokers. Analysis of cigarette smoke has shown the presence of
          substantial amounts of benzene, with the yield within the range of 0.4-104
          µg/cigarette (see Section 16.1). Analysis of breath samples from 198 smokers and
          322 non-smokers showed significantly higher (p <0.001) benzene concentrations in
          the breath of smokers (16 µg/m3) compared to non-smokers (2.5 µg/m3). Benzene
          breath levels were significantly correlated (p <0.01) with the number of cigarettes
          smoked per day (Wallace & Pelizzari, 1986; Wallace et al, 1987). Pekari et al.
          (1992) found 6 non-smokers to have venous blood benzene levels of <1-2 nM
          compared to 3 smokers (1 pack/day) with 4-13 nM in the morning and 5-8 nM in
          the afternoon. Cessation of smoking for a period (duration not stated) resulted in a
          reduction of blood benzene levels to <2 nM. In a similar study, it was found that
          the mean venous blood benzene levels of 14 smokers were significantly higher (7.0
          nM; range 3.7-12.1 nM) compared to 13 non-smokers (2.8 nM; range 1.4-5.8 nM);
          however, the number of cigarettes consumed were not stated (Hajimiragha et al,
          1989). With the exception of cigarette smoking, there were no other known
          activities undertaken by the subjects that may have resulted in benzene exposure
          prior to or during either study.

          Dermal

          A number of studies indicate that benzene is absorbed via the dermal route in
          humans. A study of 2 men exposed to benzene (approximately 0.06 g/cm2 applied
          to the forearm, 35-43 cm2, under occluded conditions for 1.25-2 h) determined the
          dermal absorption rate to be 0.4 mg/cm2/h based on urinary excretion of phenol
          (Hanke et al, 1961). Approximately 0.05% of the applied dose of [14C]-benzene
          (0.0026 mg/cm2) was absorbed when applied to the forearm skin of 4 volunteers.
          Absorption was determined by urinary excretion of radiolabel which indicated that
          absorption was rapid. Evaporative losses during the absorption period were not
          accounted for (Franz, 1984).
          The absorption of benzene due to dermal exposure to petrol has been studied in car
          mechanics having direct skin contact with petrol for 30-150 min during work on car
          fuel systems, with the concentration of benzene in the breathing zone ranging from
          0.2 ppm (detection limit) to 3.7 ppm averaged over the duration of the task. Blood
          benzene levels determined 2-9 h after exposure ranged from 3-16 nM. Based on
          expected benzene blood levels derived from the airborne concentrations, it was
          estimated that dermal absorption accounted for up to 80% of the total absorbed
          dose of benzene. The mechanics did not wear protective gloves (Laitinen et al,
          1994). However, the estimation assumed that the mechanics were exposed to non-
          detectable benzene air concentrations during the remainder of the working day and
          would therefore have overestimated the extent of skin absorption if this were not
          the case.
          In an in vitro study, benzene (pure benzene, air saturated with benzene vapour or a
          saturated aqueous solution of benzene) was shown to diffuse across hydrated
          stratum corneum prepared from human skin. Absorption, initially preceded by a lag
          phase (range: <1-1.5 h), was linear over the duration of the experiment (4 h). The
          rates of benzene absorption due to pure benzene and air saturated with benzene

Benzene                                       37

        vapour were 2.1 and 1.0 µL/cm2/h (1.8 and 0.88 mg/cm2/h) respectively. It was
        further demonstrated that the barrier characteristics of human skin alter in response
        to the presence of other solvents (Blank & McAuliffe, 1985). Lodén (1986)
        determined the amount of benzene absorbed by excised human skin to be 0.17
        mg/cm2 after 0.5 h and 0.93 mg/cm2 at steady state (13.5 h). The total absorption of
        benzene over 13.5 h in skin and receptor fluid was 1.92 mg/cm2 and the resorption
        rate (that is, the amount of substance migrating to the receptor fluid below the skin)
        was determined to be 99 µg/cm2/h.

        Oral

        No studies were identified addressing the absorption of benzene by the oral route in
        humans. Cases of accidental or intentional ingestion indicate that benzene is readily
        absorbed by the gastrointestinal tract, with a dose of 125 mg/kg proving fatal (see
        Section 11.1).

9.2     Distribution

9.2.1   Animal studies

        Inhalation

        Schrenk et al. (1941) observed that in dogs continuously exposed to the vapour,
        benzene preferentially partitions to the organs and tissues with a higher fat content,
        although considerable inter-animal variation was noted. The establishment of an
        equilibrium between most tissues (except fat) and blood levels appeared to be rapid
        (15.5 h). When exposed to various concentrations of benzene vapour (850-1320
        ppm) for periods ranging from 0.65-5 days, benzene levels were highest in bone
        marrow (57.6-64.1 mg/100 g tissue) followed by peritoneal fat (40.3-61.4 mg/100 g
        tissue) and subcutaneous fat (39.9-48.6 mg/100 g tissue). All other tissues or
        organs had substantially (generally 20-fold) lower levels of benzene. A comparable
        distribution pattern was observed when dogs were exposed to 800 ppm benzene
        vapour for 8 h/day for 38-272 days. Rickert et al. (1979) studied the distribution
        and residence times of benzene and three major metabolites, phenol, hydroquinone
        and catechol, in male rats (F344) exposed to benzene vapour (500 ppm) for up to 8
        h. The steady-state benzene concentrations at 6 h were determined for the following
        tissues: fat (164.4 µg/g), bone marrow (37.0 µg/g), kidney (25.3 µg/g), lung (15.1
        µg/g), liver (9.9 µg/g), brain (6.5 µg/g) and spleen (4.9 µg/g), while blood
        contained 11.5 µg/mL. The half-times for tissues to reach steady-state levels for
        benzene were essentially the same for all tissues (0.9-2.0 h) as were the elimination
        times (0.4-0.8 h), with the exception of fat which was 1.6 h. The concentrations of
        phenol in blood and bone marrow were maximal within 2 h after cessation of
        exposure and declined rapidly thereafter. Hydroquinone and catechol
        concentrations were sustained for 9 h after exposure with higher concentrations
        found in bone marrow.
        Ghantous & Danielsson (1986) demonstrated the transplacental distribution of
        benzene and its metabolites in mice following inhalation exposure to [14C]-
        benzene. Benzene was detected in the placenta and the foetus immediately
        following and for up to 1 h after exposure, as were benzene metabolites. The
        metabolites did not reach the same tissue concentrations as in maternal tissues and
        no metabolites were retained in the placenta or the foetus.



                                                                Priority Existing Chemical Number 21
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          Dermal

          Susten et al. (1985) examined the distribution of radiolabel after dermal application
          of undiluted [14C]-benzene and a 0.5% (v/v) solution in rubber solvent using a skin
          chamber attached to male hairless mice (HRS/J) for 4 h. Approximately 5% and
          8% of the benzene in the pure sample and rubber solvent respectively remained
          associated with the site of application while approximately 23% and 22%
          respectively was associated with the carcass. Skowronski et al. (1988) examined
          the tissue distribution of radiolabel in male rats (Sprague-Dawley) 48 h following
          the topical application of benzene (300 µL) using a glass skin chamber. The highest
          levels of radiolabel (expressed as % of initial dose per g of tissue) were found in
          the kidneys (0.026%), liver (0.013%) and treated skin (that is, below the site of
          application; 0.011%). Untreated skin gave a value of 0.002%. Subcutaneous fat
          from below the area of application gave 0.008% while subcutaneous fat from a
          different site gave 0.005% as did bone marrow. All other tissues and organs
          examined (including the brain) accounted for less than 0.04% of the initial dose.

          Oral

          Analysis of rabbit tissues and organs (1 animal) 2 days after dosing by gavage with
          [14C]-benzene (500 mg/kg) showed the highest level of radioactivity to occur in
          muscle (1.6%), fat (1.5%), liver (0.07%), stomach (0.05%), testes (0.02%) and
          kidneys (0.015%). No radioactivity was detected in the brain, spinal cord or blood
          (Parke & Wiliams, 1953). Low et al. (1989) found that the distribution of radiolabel
          in female rats (Sprague-Dawley) varied with the dose of [14C]-benzene
          administered. At 1 h after a single dose of 0.15 or 1.5 mg/kg by gavage, radiolabel
          was highest in the liver and kidneys (0.198-2.043 µg/g tissue), intermediate in
          blood (0.086-0.769 µg/mL), and lowest in the Zymbal gland, nasal cavity tissue,
          oral cavity tissue, mammary gland and bone marrow (0.034-0.547 µg/g tissue). In
          contrast, at 15 mg/kg, the amount of radiolabel found in the mammary gland and
          bone marrow had substantially increased in comparison to other tissues. At the
          highest dose, bone marrow and adipose tissue had the highest concentrations of
          benzene.

9.2.2     Human studies
          Studies of the distribution of benzene in humans are generally limited to a number
          of fatal cases of accidental or deliberate benzene exposure. Autopsy data from such
          cases indicate that benzene preferentially partitions into lipid-rich tissues.
          Analysis of tissue and fluid samples from a youth who died after sniffing benzene
          (reagent grade) showed the following order for tissue benzene content: brain, 39
          mg/kg; abdominal fat, 22.3 mg/kg; blood, 0.02 mg/mL; kidneys, 19 mg/kg; liver,
          16 mg/kg; bile, 0.011 mg/mL; stomach, 10 mg/kg and urine, 0.0006 mg/mL
          (Winek & Collom, 1971). Similar findings were demonstrated at autopsy of 3 cases
          of acute industrial benzene poisoning indicating that benzene preferentially
          distributes to lipid-rich tissues such as body fat (range: 68->120 mg/kg) and brain
          tissue (range: 58-63 mg/kg) with lesser amounts in blood (range: 30-129 mg/mL),
          liver (range: 15-38 mg/kg), lungs (positive findings) and bile (range: trace to 45
          mg/mL) (Avis & Hutton, 1993). In a similar industrial accident involving acute
          fatal benzene poisoning analysis of tissue and fluid samples revealed the following
          benzene concentrations: blood, 0.0317 mg/mL; brain, 178.7 mg/kg; lungs, 22.2
          mg/kg; heart, 182.6 mg/kg; liver, 378.6 mg/kg; kidneys, 75.2 mg/kg and urine,
          0.0023 mg/ml (Barbera et al, 1998). In the above case reports the individuals are

Benzene                                        39

        believed to have inhaled benzene vapour for some time before death occurred. In
        one case in which an individual died suddenly during an industrial accident
        involving benzene, precluding extensive inhalation of the vapour, autopsy findings
        revealed the following benzene concentrations: blood, 0.0038 mg/mL; brain, 13.8
        mg/kg; liver, 2.6 mg/kg (Tauber, 1970).
        Limited data indicate that developing foetuses and infants may be exposed to
        benzene as a result of maternal exposure. Benzene can cross the placenta and
        concentrations in umbilical cord blood have been shown to be equal to or greater
        than in maternal blood (Dowty et al, 1976). Due to the richly perfused nature of
        breast tissue and the high fat content of human milk (approximately 4%), benzene
        is expected to partition from blood into human milk from which it can transfer to
        nursing infants (Fisher et al, 1997). Qualitative analysis of 12 human milk samples
        revealed the presence of benzene in 8 of them (Pellizzari et al, 1982).

9.3     Metabolism
        The metabolism of benzene has been extensively investigated in several species of
        animals including humans. Benzene toxicity has been attributed to the formation of
        reactive metabolites that appear to exert their toxic effect in combination, with no
        one metabolite accounting for all of the observed effects. The metabolism of
        benzene has been reviewed by Ross (1996) and Snyder & Hedli (1996).

9.3.1   General metabolic pathways
        Urinalysis of several species exposed to benzene has demonstrated qualitative
        similarities in the spectrum of metabolites produced, indicating that the metabolism
        of benzene follows similar pathways between species. Urinary benzene metabolites
        identified from rabbits, rats, mice, monkeys and humans include conjugates of
        phenol, hydroquinone, catechol and 1,2,4-trihydroxybenzene while phenyl-
        mercapturic acid and trans,trans-muconic acid have also been identified. The
        conjugates are principally glucuronides and sulfates (Parke & Williams, 1953;
        Rothman et al, 1998; Sabourin et al, 1988, 1992). Analysis of rat and human blood
        samples has further revealed the presence of benzene oxide and its S-
        phenylcysteine adducts following benzene exposure (Bechtold et al, 1992a, 1992b;
        Lovern et al, 1997). The general metabolic pathways for benzene metabolism are
        provided in Figure 9.1. The initial step in the formation of toxic metabolites is the
        conversion of benzene to the benzene oxide/oxepin which can be further
        metabolised to phenolic compounds or cleaved to give trans,trans-muconaldehyde.
        Detoxification pathways primarily involve conversion of benzene oxide to pre-
        phenylmercapturic acid and phenylmercapturic acid while the phenolic compounds
        form glucuronide and sulfate conjugates.




                                                               Priority Existing Chemical Number 21
                                             40

          Figure 9.1. The metabolism of benzene, with question marks indicating
          suspected pathways for which definitive evidence is lacking (after Sabourin
          et al. (1988) and Schlosser et al. (1993))

                                                                                                                O
                                                                            Benzene oxide
                                                                               oxepin                               OH
                                                                                              HO
                                                                                                               trans, trans-
                                             Benzene                                                  O
                                                                                   O                           Muconic acid
                                                                                              ?
          Pre-phenylmercapturic acid                                                                            O
                                                                                     OH ?
                                   OH                                                                               H
                                                                                                  H
                                                               O
                                                                                                      O        trans, trans-
                                                                                    OH
                                       S-N-Acetyl-Cys
                                                                                                              Muconaldehyde
                                                                                    Benzene
                                                             Benzene
                                                                                   dihydrodiol
                                                              oxide

                                                                                       OH
                                                               OH


                                                                                       OH
                                       S-N-Acetyl-Cys
          Phenylmercapturic acid                             Phenol                Catechol




                                                                                       OH
                                                               OH


                                                                       HO              OH
                                                 HO
                                                                                    1,2,4-Trihydroxybenzene
                                              Hydroquinone




          The primary site for benzene metabolism is the liver. It has been observed that
          animals that have undergone partial hepatectomy metabolise less benzene and
          exhibit reduced benzene-mediated toxicity compared to animals with intact livers
          (Sammet et al, 1979). The initial biotransformation of benzene involves oxidation
          by the action of a cytochrome-P450 (CYP) to produce the benzene oxide/oxepin
          intermediate (Jerina et al, 1968). Studies of liver microsomal preparations from rats
          and rabbits, using inhibitor and immunochemical techniques, have identified the
          cytochrome as CYP2E1 (Johansson & Ingelman-Sundberg, 1988; Koop et al, 1989;
          Nakajima et al, 1989). Similar studies with human liver microsomal preparations
          have shown CYP2E1 to be the major cytochrome involved in the metabolism of
          benzene by humans (Guengerich et al, 1991). Valentine et al. (1996) confirmed the
          role of CYP2E1 in the in vivo metabolism of benzene using transgenic CYP2E1
          knockout mice (cyp2e1-/-). Analysis of urine samples after exposure to [14C]-
          benzene by nose-only inhalation showed reduced levels of urinary metabolites
          compared to wild-type mice (cyp2e1+/+). The study further demonstrated that, while
          oxidative metabolism of benzene occurs primarily through CYP2E1, other
          cytochromes are involved.
          Studies of rat liver microsomes have shown there to be high affinity (Km = 20 µM)
          and low affinity (Km = 0.3 mM) binding sites for benzene (Johansson & Ingelman-
          Sundberg, 1988). Nakajima et al. (1989), using monoclonal antibodies, identified
          two distinct rat enzymes, a high affinity and a low affinity binding type involved in
          benzene oxidation. Subsequent studies of rat microsomal P450 isozymes, CYP2E1,
          CYP2C11/6, CYP1A1/2 and CYP2B1/2, by Nakajima et al. (1992) using
          monoclonal antibodies showed that all four isozymes are involved in the initial
          oxidation of benzene. However, while CYP2E1 has been characterised as a high
          affinity enzyme with respect to benzene metabolism, CYP2B1/2 exhibits low
          affinity but high capacity (Gut et al, 1996; Nakajima et al, 1989) and CYP2C11/6

Benzene                                                       41

        and CYP1A1/2 exhibit low affinity and low efficiency towards benzene (Nakajima
        et al., 1992).
        Several studies have demonstrated the inducible nature of CYP2E1 and subsequent
        enhancement of benzene metabolism by phenobarbital, acetone or ethanol
        treatment of rats (Johansson & Ingelman-Sundberg, 1988; Koop et al., 1989;
        Nakajima et al., 1989). In addition, it has been demonstrated that benzene is able to
        stimulate its own metabolism by inducing CYP2E1 activity (Arinç et al., 1991; Gut
        et al., 1993). However, it has also been demonstrated in mice that repeated oral
        exposure to benzene can diminish CYP2E1 activity (Daiker et al., 1996). One
        postulated mechanism for reduced cytochrome activity, demonstrated in vitro,
        requires inactivation of the cytochrome by quinones formed by oxidation of
        hydroquinone, catechol and 1,2,4-trihydroxybenzene (Soucek et al., 1994).
        The initial oxidation product of benzene, benzene oxide, has been estimated to have
        a half-life, in vitro, of approximately 8 min in blood (Lindstrom et al., 1997). Thus
        the oxide has sufficient stability to allow it to participate in a variety of reactions.
        Minor reactions of benzene oxide include alkylation with DNA and RNA (Mueller
        et al, 1987) and proteins (Bechtold et al, 1992a, 1992b) while epoxide hydrolase
        converts it to benzene dihydrodiol (1,2-dihydroxycyclohexadiene).
        The presence of benzene oxide in blood has been detected by the presence of S-
        phenylcysteine adducts of haemoglobin and albumin (Bechtold et al, 1992a;
        1992b). Haemoglobin adducts were detected in the blood of rats (F344) and mice
        (B6C3F1) after inhalation exposure (600 ppm, 6 h/day, 5 days/week for 2 weeks) or
        gavage (rats only; 0, 100, 1000 or 10,000 µmol/kg). Albumin adducts were also
        detected in the plasma of rats exposed to benzene vapour (Bechtold & Henderson,
        1993). While the haemoglobin adduct has been found to be relatively stable in the
        rat (F344) with decay rates consistent with the life-span of erythrocytes
        (approximately 60 days), albumin adducts were found to have a half-life of 0.4
        days compared to unmodified albumin (half-life approximately 3 days) (Troester et
        al, 2000). Lindstrom et al. (1998) estimated the half-life of benzene oxide in blood,
        under in vitro conditions, to be approximately 6.6 min in mice (B6C3F1), 7.9 min
        in rats (F344) and 7.2 min in humans. When benzene oxide (0-184 µM) was
        incubated with mouse, rat or human blood for 3 h it was observed that haemoglobin
        adduct formation was proportional to the oxide concentration. The order of
        reactivity for the oxide with haemoglobin was rat >> mouse > human. Negligible
        haemoglobin adduct formation was observed with human blood. All three species
        formed albumin adducts with the order being rat  human > mouse.

9.3.2   Formation of phenolic metabolites
        Studies with microsomal preparations, which preclude conjugation (detoxification)
        pathways, indicate that the major pathway for the further metabolism of benzene
        oxide involves the spontaneous rearrangement to phenol (Jerina & Daly, 1974;
        Jerina et al, 1968). It has been demonstrated, using liver microsomes and
        reconstituted enzyme systems, that phenol can also arise by the direct oxidation of
        benzene by hydroxyl radicals derived from the reduction of molecular oxygen by
        cytochrome P450 activity (Johannson & Ingelman-Sundberg, 1983). However,
        Gorsky & Coon (1985) observed that when benzene is present at concentrations
        approaching the Km of CYP2E1 for benzene, hydroxyl radicals do not contribute
        significantly to benzene oxidation. The further oxidation of phenol by cytochrome
        P450 results in hydroquinone (Koop et al, 1989; Valentine et al, 1996) and catechol
        while 1,2,4-trihydroxybenzene arises from the P450-mediated oxidation of either

                                                                 Priority Existing Chemical Number 21
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          hydroquinone or catechol (Schlosser et al., 1993). In addition, catechol can be
          produced from benzene dihydrodiol by the action of dihydrodiol dehydrogenase
          (Bolcsak & Nerland, 1983).
          The hydroquinone species derived from benzene, that is, hydroquinone, catechol
          and 1,2,4-trihydroxybenzene, readily undergo autoxidation to their respective
          semiquinone and quinone forms and the presence of peroxidases facilitate the
          oxidation process (Schlosser et al., 1989; Smith et al., 1989). Quinones are
          chemically reactive and capable of forming adducts with macromolecules. Further
          discussion of the secondary metabolism of benzene-derived phenol and
          hydroquinone species, along with their biological effects, is presented in Section
          12.
          The detoxification of the phenolic benzene metabolites occurs primarily by
          conjugation to glutathione (GSH), glucuronide or sulfate (Parke & Williams, 1953).
          Conjugation of benzene oxide with GSH by glutathione-S-transferase (GST) results
          in the formation of pre-phenylmercapturic acid and, by dehydrogenation,
          phenylmercapturic acid, both of which have been identified as urinary metabolites.
          The major metabolites, phenol, hydroquinone, catechol and 1,2,4-
          trihydroxybenzene, all form glucuronide and sulfate conjugates (Parke & Williams,
          1953; Sabourin et al., 1988).

9.3.3     Formation of trans,trans-muconaldehyde
          Cleavage of the oxidised aromatic ring results in the formation of trans,trans-
          muconaldehyde which is subsequently converted to trans,trans-muconic acid prior
          to excretion. A number of in vivo studies of several animal species, including
          humans, have shown trans,trans-muconic acid to be an end-stage product of
          benzene metabolism (Parke & Williams, 1953; Rothman et al., 1998; Sabourin et
          al., 1988). While the opening of the benzene ring and subsequent formation of
          muconic acid have been shown to occur in isolated perfused rat livers, as has the
          conversion of trans,trans-muconaldehyde to trans,trans-muconic acid (Grotz et al.,
          1994), the precise mechanism of ring opening remains elusive. It has been
          proposed that benzene oxide, while in the oxepin state, undergoes secondary
          oxidation by cytochrome P450 to produce trans,trans-muconaldehyde (Davies &
          Whitham, 1977) and small quantities of trans,trans-muconaldehyde have been
          found to be produced by mouse liver microsomal preparations on incubation with
          benzene (Latriano et al, 1986). However, hydroxyl radicals have also been
          implicated in the formation of trans,trans-muconaldehyde. Incubation of benzene
          with Fenton's reagent, which produces reactive oxygen species, results in the
          formation of cis,trans-muconaldehyde which, through a series of rearrangements,
          yields the trans,trans-isomer (Zhang et al., 1995). An alternative proposed
          mechanism for aldehyde formation requires cleavage of benzene dihydrodiol
          (Latriano et al., 1986), however, the aldehyde was not produced when benzene
          dihydrodiol was incubated with Fenton's reagent (Zhang et al., 1995). The
          subsequent conversion of trans,trans-muconaldehyde to trans,trans-muconic acid
          involves several steps requiring the action of an aldehyde dehydrogenase (Kirley et
          al, 1989; Zhang et al, 1993). Conjugation of trans,trans-muconaldehyde with GSH
          via hepatic GST has been demonstrated as a detoxification pathway for this
          metabolite (Goon et al., 1993a, 1993b).




Benzene                                       43

9.4     Elimination and excretion

9.4.1   Animal data

        Inhalation

        Benzene was detected in the urine of dogs exposed to benzene vapour (850-1320
        ppm) at levels ranging from 29.3-48.3 mg/100 g (Schrenk et al, 1941). Sabourin et
        al. (1989) identified the urinary metabolites of benzene metabolism in rats and mice
        following inhalation exposure to benzene vapour (nose-only) for 6 h. The results
        are presented in Table 9.1.

        Table 9.1: Major urinary metabolites after inhalation of benzene, expressed as
        a percentage of total urinary metabolites from 24-h samples (adapted from
        Sabourin et al. (1989))

                      Dose       Phenol     Hydroquinone    Catechol      Pre-phenyl-        Muconic
        Species      (ppm)     conjugates    conjugates    conjugates   mercapturic acid      acid
        Rat (F344)      5         57            5.7           ND*               9.5              19
                      600         74            2.0           ND                17               4.0
                        5         37             33           ND                6.0              23
        Mouse
        (B6C3F1)      600         67             11           ND                15               5.0

        * ND = not detected.


        Dermal

        Franz (1984) observed that peak excretion of radioactivity in the urine of rhesus
        monkeys after the application of 0.5 mL of [14C]-benzene occurred during the first
        2 h and decreased rapidly thereafter but remained detectable for up to 30 h.
        Skowronski et al. (1988) found that after the topical application of 300 µL of [14C]-
        benzene to male rats (Sprague-Dawley) by means of a glass skin chamber, the
        major excretory route for radiolabel was in the urine, with substantially lesser
        amounts in faeces and expired air. Excretion in the urine was greatest during the
        12- to 24-h interval after application, accounting for 58.8% of the initial dose with
        68.4% recovered in 24 h and 86.2% after 48 h. In contrast, 0.2% of the initial dose
        was recovered over 48 h in the faeces. Expired air accounted for 12.0% in the first
        24 h with the following 24 h accounting for only a further 0.8%.

        Oral

        Analysis of urinary benzene metabolites from several species following
        administration of [3H]-benzene by gavage has shown similar profiles of
        metabolites. As indicated in Table 9.2, the principal urinary metabolites for the
        species shown are conjugates (glucuronides and sulfates) of phenol and, to a lesser
        extent, hydroquinone. The mouse is quantitatively different from the other species
        with a substantially higher production of hydroquinone conjugates and trans,trans-
        muconic acid. In addition to species differences, the table shows the effect of
        changes in dose levels on urinary metabolites for rats and mice. Increasing the dose
        of benzene leads to an increase in the excretion of phenol conjugates and a decrease
        in hydroquinone conjugates by the mouse but no substantial change in the rat. In
        contrast, trans,trans-muconic acid excretion is diminished in both the rat and the
        mouse at higher doses.



                                                                    Priority Existing Chemical Number 21
                                                 44

          Table 9.2: Major urinary metabolites after oral administration of benzene,
          expressed as a percentage of total urinary metabolites from 24-h samples
          (adapted from Parke & Williams (1953), and Sabourin et al. (1989, 1992))

                        Dose       Phenol     Hydroquinone    Catechol      Pre-phenyl-    Muconic
          Species      (mg/kg)   conjugates    conjugates    conjugates   mercapturic acid  acid
          Rat (F344)      1         70            4.0           ND*             11           13
                          10        71            2.8           ND              15           10
                         200        75            2.0           ND              18          5.0
                          1         30             47           ND              2.7          20
          Mouse
          (B6C3F1)        10        38             39           1.0             4.5          16
                         200        63             16           ND              11          9.0
          Rabbit         340        24            4.8           2.2           No data       1.3

          * ND = not detected.

          Within 2 days of administering [14C]-benzene (0.34-0.5 g/kg) to rabbits by gavage,
          approximately 45% of the dose was detected in expired air (43% as unchanged
          benzene and 1.5% as carbon dioxide) and approximately 35% appeared in the
          urine. Urinary radiolabel was predominantly in the form of conjugated phenols,
          with phenol comprising approximately 23% of the administered dose and with
          hydroquinone, catechol and 1,2,4-benzenetriol making up 4.8%, 2.2% and 0.3%
          respectively (as conjugates). Approximately 1.3% of the dose was recovered as
          trans,trans-muconic acid and a further 0.5% as phenylmercapturic acid. No
          diphenyl or its derivatives were detected in the urine. The residual radioactivity
          (5% to 10%) was associated with the tissues and faeces (Parke & Williams, 1953).
          The elimination of benzene by the metabolic route appears to be saturable. Oral
          doses of [14C]-benzene 15 mg/kg resulted in the excretion in the urine over 48 h of
          >89% of the administered radioactivity by rats (F344 or Sprague-Dawley). Doses
          50 mg/kg bw resulted in a dose-dependent reduction in urinary excretion and a
          corresponding dose-dependent increase in exhaled 14C, predominantly as the parent
          molecule. At all doses, residual 14C in the carcass amounted to less than 8%.
          Excretion in the faeces did not exceed 11% of the administered dose up to the
          maximum dose of 300 mg/kg. Mice (B6C3F1) demonstrated similar elimination
          characteristics to rats (Sabourin et al, 1987).

          Other routes

          Analysis of urine from male cynomolgus monkeys administered [14C]-benzene (5,
          50 and 500 mg/kg) by intraperitoneal injection revealed that urinary excretion of
          radiolabel diminished with increasing dose. At 5 mg/kg an average of 56% of the
          administered dose was recovered in the urine compared to 13% at 500 mg/kg over
          a 95-h period. In contrast, recovery of radiolabel from the urine of chimpanzees
          administered a dose of benzene (1 mg/kg) by intravenous injection was complete
          after 24 h with >90% of the radiolabel collected within the first 8 h. As shown in
          Table 9.3, phenyl sulfate was found to be the major metabolite (45-74% of total
          urinary metabolites) for all doses. Lesser amounts of hydroquinone glucuronide,
          muconic acid, phenyl glucuronide, hydroquinone sulfate and catechol sulfate were
          also present. No unconjugated metabolites were detected. The amount of excreted
          hydroquinone sulfate and muconic acid decreased and phenyl glucuronide and
          catechol glucuronide increased as the benzene dose increased. A similar urinary
          profile of metabolites was obtained with female chimpanzees administered an
          intravenous dose of [14C]-benzene (1 mg/kg), although the formation of catechol
          conjugates was not detected (Sabourin et al, 1992).

Benzene                                           45

        Table 9.3: Major urinary metabolites after intraperitoneal administration of
        benzene, expressed as a percentage of total urinary metabolites from 24-h
        samples (adapted from Sabourin et al. (1992))

                       Dose     Phenol     Hydroquinone    Catechol       Pre-phenyl-    Muconic
        Species       (mg/kg) conjugates    conjugates    conjugates    mercapturic acid  acid
                          5       61            27           8.0              No data           4.4
        Cynomolgus
        monkey           50       73            15           6.0              No data           3.1
                        500       78           8.9           9.9              No data           1.3
        Chimpanzee        1       75           8.0           ND*                0.5             5.5

        * ND = not detected.


9.4.2   Human data

        Inhalation

        The elimination of benzene across the lungs of 10 subjects was studied. Subjects
        inhaled benzene (47-84 ppm) for 2-3 h after which breath samples were taken over
        a further 5-7 h. The results showed 16.4-41.6% of the absorbed benzene to be
        exhaled with the greatest rate occurring during the first hour. Excretion in the urine
        accounted for a maximum of 0.2% of the absorbed dose (Srbova et al, 1950). It
        appears that urinary benzene metabolites were not measured by the protocol
        employed. Comparable results were produced after a 4-h exposure to benzene
        vapour (52-62 ppm) where 6 volunteers (3 males and 3 females) were shown to
        exhale 16.3% (men) and 17.2% (females) of the inhaled benzene (Nomiyama &
        Nomiyama, 1974a). The ratio of respiratory elimination of non-metabolised
        benzene to retained benzene was determined to be 114.8% for males (considered by
        the authors to be unreliable) and 39.8% for females (Nomiyama & Nomiyama,
        1974b). Using 4 volunteers (male non-smokers) exposed to benzene vapour (mean
        daily exposure 26.2-42.2 ppm) for 5 consecutive daily 6-h periods, Berlin et al.
        (1980) showed the clearance of benzene across the lungs to be biphasic with a half-
        time of 2.6 h for the rapid phase and 24 h for the slow phase. At higher benzene
        concentrations (99 ppm for 1 h), Sherwood (1988) identified one individual with an
        initial rapid phase and 2-3 slower phases while urinary excretion displayed a
        biphasic pattern.
        Ghittori et al. (1993) found a linear correlation between benzene in the breathing
        zone and unmetabolised benzene in the urine of workers. Subsequently, Ghittori et
        al. (1995) identified a linear relationship between benzene in the breathing zone of
        workers and urinary levels of trans,trans-muconic acid and phenylmercapturic
        acid.

        Dermal and oral

        Peak excretion of radioactivity in the urine of 4 human volunteers after the
        application of 0.4 ml of [14C]-benzene to the ventral forearm occurred rapidly
        within the first 2 h and decreased rapidly thereafter but remained detectable for up
        to 30 h (Franz, 1984).
        No studies were identified that address the elimination of benzene or its metabolites
        from humans after exposure by the oral route.




                                                                   Priority Existing Chemical Number 21
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9.5       Comparative kinetics and metabolism
          As discussed above, CYP2E1 is a high affinity, low capacity enzyme.
          Consequently, the pathway for the hepatic metabolism of benzene becomes
          saturated at relatively low doses. Henderson et al. (1989) found a single oral dose
          of benzene of 50 mg/kg or greater, when administered to rats or mice, resulted in
          saturation of the metabolic pathway with consequent loss of unmetabolised
          benzene by exhalation. Rats and mice administered an oral dose of 150 mg/kg
          exhaled approximately 50% and 85% respectively as unmetabolised benzene. This
          loss of benzene by exhalation becomes a limiting factor in the maximal tissue
          concentrations of metabolites that can be achieved following oral dosing. However,
          higher tissue concentrations of benzene metabolites can be achieved by the
          inhalation route. It has been observed that mice accumulate substantially more
          benzene metabolites than rats during inhalation exposure. This appears to be due to
          physiologic and metabolic differences between the two species. Mice have a higher
          respiratory minute volume per kg body weight compared to rats allowing for the
          blood benzene level to achieve equilibrium faster than in the rat (Sabourin et al,
          1989, 1990). Mice also have a higher metabolic rate, based on increased oxygen
          consumption (approximately 1.8 times greater than the rat), resulting in faster
          removal of benzene from the circulation. This allows for higher levels of
          metabolites to accumulate within body tissues compared to the rat. Doses of
          benzene that lead to metabolic saturation also produce changes in the metabolic
          profile of benzene metabolites (Sabourin et al, 1989; Daiker et al, 1996).

9.5.1     Oral studies
          The content of water-soluble benzene metabolites in bone marrow has been
          examined following oral administration of benzene to male rats and mice. Table 9.4
          shows that phenol conjugates accounted for the major proportion of metabolites in
          the rat and remained relatively constant over the dose range as did the mercapturic
          acid derivatives. The trans,trans-muconic acid content diminished with increasing
          doses of benzene and hydroquinone conjugates remained at relatively low levels. In
          contrast, the mouse produced comparable bone marrow levels of phenol and
          hydroquinone conjugates at the lowest dose with the amount of hydroquinone
          conjugates decreasing as the benzene dose increased. Both phenyl mercapturic acid
          and trans,trans-muconic acid increased with the dose of benzene (Sabourin et al,
          1989).

          Table 9.4: Major bone marrow metabolites after oral administration of
          benzene, expressed as a percentage of total water-soluble metabolites from
          pooled samples (adapted from Sabourin et al. (1989))

                                                           Pre-phenyl-    Phenyl-
                                              Hydroquinone mercapturic   mercapturic   Muconic
                        Dose       Phenol
                                                                                        acid
          Species      (mg/kg)   conjugates    conjugates     acid          acid
          Rat (F344)      1         75            ND*          15            ND          10
                          10        74            3.0          15            4.0         4.0
                         200        84            2.3          13            ND          0.2
                          1         50             50          ND            ND          ND
          Mouse
          (B6C3F1)        10        52             35          ND            13          ND
                         200        56            9.0          ND            27          8.0

          * ND = not detected.




Benzene                                          47

9.5.2   Inhalation studies

        Animal data

        The profile of metabolites produced by male rats (F344) and mice (B6C3F1)
        exposed (nose-only) to benzene vapour for 6 h at 5 ppm or 600 ppm is presented in
        Table 9.1. Phenol conjugates account for the major proportion of metabolites
        produced at either concentration by both species. At 5 ppm, hydroquinone
        conjugates and trans,trans-muconic acid are present in higher amounts than at 600
        ppm while pre-phenylmercapturic acid increases with the administered dose
        (Sabourin et al, 1989).
        Tissue and blood levels of non-conjugated benzene metabolites were determined in
        male rats (F344) and mice (B6C3F1) after inhalation of benzene vapour (50 ppm)
        for 6 h. While phenol, hydroquinone and catechol could not be detected in the liver,
        lung or blood of the rat, detectable levels of phenol and hydroquinone were found
        in the mouse with catechol detected only in the liver. The data for male rats and
        mice are presented in Table 9.5.

        Table 9.5: Major non-conjugated benzene metabolites (nmol/g tissue) in rat
        and mouse tissues (adapted from Sabourin et al. (1988))

                                             F344 rats                      B6C3F1 mice
        Metabolite                   Liver    Lung       Blood     Liver       Lung        Blood
        Phenol                       ND*        ND        ND        0.3         0.6          1.3
        Hydroquinone                 ND         ND        ND        2.1         1.2          4.3
        Catechol                     ND         ND        ND        0.3         ND           ND

        * ND = not detected.

        In contrast, conjugated derivatives of phenol, hydroquinone and catechol were
        detected in substantially greater amounts in the tissues and blood of both species
        (Table 9.6).

        Table 9.6: Major conjugated benzene metabolites (nmol/g tissue) in rat and
        mouse tissues (adapted from Sabourin et al. (1988))

                                             F344 rats                      B6C3F1 mice
        Metabolite                   Liver    Lung       Blood     Liver       Lung        Blood
        Phenylglucoronide            ND*        ND        ND        6.3         1.2          ND
        Cathecholglucoronide          1.0      ND         ND        0.8         0.5          ND
        Hydroquinoneglucoronide       0.4       ND        ND         26          15          12
        Phenylsulfate                 1.5       15        20         28          36          36
        Hydroquinone monosulfate     ND         ND        ND        2.8         0.6          ND
        Pre-phenylmercapturic acid    6.9       0.9       ND         44         2.1          2.3
        Phenylmercapturic acid       ND        ND         ND        ND          ND           ND
        Muconic acid                  8.4       1.9       0.7       228          18          1.0

        * ND = not detected.

        As shown in the table, the level of trans,trans-muconic acid in the mouse liver was
        very much greater than observed in lung tissue or blood for either species (Sabourin
        et al, 1988). Henderson et al. (1989) observed that the mouse metabolised more of
        an inhaled dose of benzene than the rat under comparable conditions and that a
        greater proportion was converted to the putative toxic metabolites. It was found that


                                                                 Priority Existing Chemical Number 21
                                                 48

          detoxification (conjugation) pathways were low-affinity, high-capacity whereas
          toxic metabolite formation appeared to be high-affinity, low capacity.
          A short-term benzene inhalation study (exposure for 6 h/day for 6 days) with male
          Swiss mice showed that at 199 ppm or less, the major metabolite in blood was
          phenylsulfate while above 199 ppm a dose-dependent increase in phenyl-
          glucuronide occurred. At all benzene concentrations, the blood phenol level
          increased in a dose-dependent manner (Wells & Nerland, 1991).

          Human data

          Studies of humans are generally limited to analysis of urine or blood samples of
          workers occupationally exposed to benzene.
          Bechtold and Henderson (1993) conducted analyses on the urine and blood of non-
          smoking female workers exposed to benzene vapour. Five women exposed to
          approximately 4.4 ppm for 8 h showed the presence of elevated urinary levels of
          trans,trans-muconic acid (6.2 µg/mg creatinine) compared to 8 females with no
          known exposure (0.27 µg/mg creatinine). Blood samples from 10 women exposed
          to benzene vapour (0-23.1 ppm) showed a linear relationship between benzene
          exposure levels and albumin-S-phenylcysteine adducts, however, no haemoglobin-
          S-phenylcysteine adducts were detected.

9.5.3     Dermal studies
          Comparative studies of the metabolism of benzene after dermal absorption were not
          identified.

9.5.4     In vitro studies
          The metabolism of low levels of benzene by microsomes prepared from 10 human
          liver samples was investigated. When [14C]-benzene (3.4 µM) was incubated with
          microsomal preparations, the major metabolites were phenol and hydroquinone
          accounting for up to 48% of the recovered radiolabel while minor metabolites were
          catechol and 1,2,4-trihydroxybenzene which accounted for <2% and 0.2%
          respectively. A further metabolite, tentatively identified as 2,2'-biphenol,
          accounted for approximately 4% of radiolabel. The CYP2E1 activities of the
          individual liver samples were found to vary 13-fold as determined by a standard
          hydroxylation assay with activities ranging between 0.253 to 3.266 nmol/mg/min.
          When benzene was used as the substrate, a 6-fold difference between liver samples
          was noted that ranged from 10% to 59%. Comparison of individual liver samples
          over a 16-min incubation period showed that phenol was the major metabolite
          formed with the exception of two samples where hydroquinone predominated.
          These latter two samples had higher CYP2E1 activities and the sample with the
          highest activity produced equal quantities of phenol and hydroquinone. The rate of
          benzene metabolism by each of the 10 liver samples correlated with their CYP2E1
          activity (Seaton et al, 1994). In a subsequent report by Seaton et al. (1995)
          addressing the in vitro sulfonation of phenol and glucuronidation of hydroquinone
          by human liver cytosolic and microsomal preparations from 10 donors, there was a
          3-fold difference in the rates of conjugation for each reaction.




Benzene                                      49

9.6   Summary
      Benzene is readily absorbed by the inhalation, oral and dermal routes in all animal
      species tested. In humans, the absorption of benzene by the inhalation route is
      maximal within minutes of exposure and subsequently declines to a constant level.
      Dermal absorption is generally low compared to inhalation due to volatilisation,
      with less than 1% of an applied dose being absorbed unless skin exposure is
      prolonged. The variation in benzene absorption between individuals following
      inhalation is high. Partitioning of benzene is expected to occur into lipid-rich
      tissues due to the lipophilic nature of benzene. Several studies have confirmed that
      benzene accumulates in the adipose tissue, bone marrow and brain of animals and
      humans.
      The metabolism of benzene is qualitatively similar between various animal species,
      including humans, and proceeds predominantly by hepatic CYP2E1-mediated
      oxidation of the aromatic ring to yield benzene oxide/oxepin. Subsequent pathways
      for metabolism of the oxide/oxepin include spontaneous rearrangement to phenol
      or ring cleavage to give trans,trans-muconaldehyde. Phenol can be further oxidized
      to polyphenols (hydroquinone, catechol and 1,2,4-trihydroxybenzene).
      Detoxification pathways involve conjugation of benzene oxide or trans,trans-
      muconaldehyde with GSH while the phenolic metabolites are conjugated to either
      glucuronate or sulfate. The metabolism of benzene is rapid with water-soluble
      metabolites appearing in the urine within 2 h of exposure. The major urinary
      metabolites from several species are conjugates of phenol followed by lesser and
      variable amounts of hydroquinone conjugates and of pre-phenylmercapturic acid
      and trans,trans-muconic acid. Conjugates of catechol have been detected in small
      amounts in the urine of mice, rabbits and primates.
      Due to the limited capacity of hepatic CYP2E1 to metabolise benzene, a substantial
      proportion of absorbed benzene is eliminated unchanged in exhaled air, with the
      remainder being eliminated via the urine, principally as metabolites. Urinary
      excretion appears to be biphasic with a fast phase followed by a prolonged phase,
      suggesting the slow removal of benzene from adipose tissue. Due to the readily
      saturable nature of benzene metabolism, exposure at higher doses results in greater
      elimination of unmetabolised benzene via exhalation.
      While comparative studies of urinary benzene metabolites have shown common
      pathways for benzene metabolism to exist between various species, physiological
      as well as metabolic differences contribute to some of the observed differences.
      The easily saturated nature of benzene metabolic pathways and greater respiratory
      minute volume of the mouse allow the mouse to expire more of an oral dose of
      benzene compared to the rat. Similarly, respiratory differences and the greater
      metabolic rate of the mouse allow tissue levels of benzene metabolites to reach
      higher levels compared to the rat.




                                                             Priority Existing Chemical Number 21
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          10. Effects on Laboratory
              Mammals and Other Test
              Systems

          The aim of this section is to describe the toxic effects and corresponding effect
          levels of benzene in animals. In the case of end points studied extensively in
          humans (mainly haematological and genetic toxicity), the assessment is based on
          recent reviews by ATSDR (1997) and USEPA (USEPA 1998a, 1998c). For other
          adverse effects, individual animal studies have been reviewed for this assessment.
          These include all carcinogenicity studies as well as investigations of the toxic
          effects of benzene on the central nervous system (CNS), immune function,
          reproductive organs and foetus.
          Most of the available studies do not comply with Good Laboratory Practices (GLP)
          or international standards such as the OECD Test Guidelines. In consequence, all
          available publications with a relevant end point have been included in the review
          irrespective of their compliance with formal quality criteria. However, studies
          providing insufficient scientific detail to permit a critical appraisal of their findings
          are clearly identified as such. Unless otherwise indicated, only effects that were
          statistically different (p <0.05) from controls have been considered.

10.1      Acute toxicity
          The acute toxicity of benzene in experimental animals is summarised in Table 10.1,
          which includes the highest and the lowest values reported in the published
          literature. Mortality is due to cardio-respiratory arrest from severe CNS depression
          and/or cardiac arrhythmia (Nahum & Hoff, 1934).
          Table 10.1: Acute toxicity of benzene

          Route        Species       Measure*          Results     Sex                Reference
          Inhalation   Mouse         LC50(7 h)        9980 ppm     Not specified      Svirbely et al. (1943)
                       Rat           LC50(4 h)       13,700 ppm    Females            Drew & Fouts (1974)
                                                     16,000 ppm    Males              Smyth et al. (1962)
                                     ALD(4 h)
                                                     45,000 ppm    Both sexes         Carpenter et al. (1944)
                       Rabbit        LC100(30 min)
                       Mouse         LD50
          Oral                                       4700 mg/kg    Not specified      RTECS (2000)
                                                     6500 mg/kg    Males              Spanò et al. (1989)
                                                      810 mg/kg    Males              Cornish & Ryan (1965)
                       Rat           LD50
                                                     5600 mg/kg    Males              Wolf et al. (1956)
                                                     9900 mg/kg    Males              Smyth et al. (1962)
                                     LD50            >8200 mg/kg                      Roudabush et al. (1965)
          Dermal                                                   Male guinea pigs
                       Guinea
                                                                   Male and female
                       pig, rabbit
                                                                   rabbits
          SC           Mouse         ALD             3500 mg/kg    Males              Watanabe & Yoshida (1970)

          * ALD = approximate lethal dose; LC50 = median lethal concentration; LC100 = concentration leading to
          100% mortality; LD50 = median lethal dose; SC = subcutaneous.




Benzene                                                   51

10.2   Irritation and corrosivity
       Several rabbit tests for skin and eye irritation have been reported. From 10-20 daily
       applications of undiluted benzene to the skin caused redness, oedema, skin peeling
       and blistering (Wolf et al, 1956). The chemical was also reported to cause skin
       irritation in a test according to OECD Test Guideline No. 404, however, further
       details were not provided (Jacobs, 1992, as cited in OECD, 2000). One or two
       drops of undiluted benzene applied to the eye produced moderate irritation of the
       conjunctiva and very slight, transient corneal injury (Wolf et al, 1956). Smyth et al.
       (1962) reported similar skin and eye lesions rated as grade 3 on a 10-point scale.
       Rats exposed to benzene vapours for 6 h/day, 5 days/week for 10 weeks exhibited
       lacrimation during the first 3 weeks of exposure to levels 10 ppm (Shell, 1980, as
       cited in ATSDR, 1997).

10.3   Sensitisation
       There are no studies of skin or respiratory sensitisation to benzene in animals.

10.4   Repeated dose toxicity (other than carcinogenicity)

10.4.1 Short-term exposure
       The toxic effects of benzene have been investigated in numerous short-term studies
       in mice and rats. In these studies, benzene was administered orally in vegetable oil
       or drinking water for 2 days to 24 weeks, or by whole-body exposure to vapours,
       usually for 6 h/day, 5 days/week. The dose levels tested ranged from 1-600
       mg/kg/day by mouth and from 0.44-6600 ppm by inhalation. Repeated dose dermal
       studies could not be identified.

       Neurotoxicity

       Evans et al. (1981) exposed male CD-1 and C57BL mice to inhalation of 0, 300 or
       900 ppm benzene for 6 h/day. After the 5th exposure, the mice were observed and
       scored for 7 behavioural categories at 30 and 75 min post-exposure. In both strains,
       there were increases in the frequency of eating and grooming, and a decrease in
       sleeping and resting. These stimulatory effects were more pronounced at 75 than at
       30 min post-exposure and in the 300 than in the 900 ppm exposure groups,
       indicating an association with brain concentrations below a certain level.
       Immediately following single and repeated 6-h exposures of male mice to 100, 300,
       1000 or 3000 ppm benzene, there were increased milk licking at 100 ppm and a
       reduction in hind limb grip strength at 1000 ppm, but no effects on locomotor
       activity (Dempster et al, 1984). In the absence of motor disturbances, hind limb
       grip strength is a test for unconditional reflexes. Milk licking, however, may be
       influenced by hunger and mucosal membrane irritation.
       In groups of 10 adult male mice exposed to 0, 0.78, 3.13 or 12.52 ppm benzene for
       2 h/day, 6 days/week for 30 days, tests for behaviour (time taken to run to a safety
       area in a Y-maze following an electric shock) and forelimb grip strength showed
       stimulation at 0.78 ppm and depression at 12.52 ppm, but no effect on locomotor
       activity (Li et al, 1992). Compared to unexposed controls, the average change in
       the frequency of rapid shock responders was +30% at 0.78 ppm and ­24% at 12.5
       ppm. For grip strength, it was +77% and ­11% respectively. As the concentration

                                                               Priority Existing Chemical Number 21
                                            52

          of benzene in the air was not checked after the first three days of the experiment
          and there were extraordinary changes in bone marrow morphology on day 30,
          actual benzene exposure may have been higher than reported (USEPA, 1998c). On
          the other hand, the changes in behaviour were observed already on the first 1-2
          days of exposure when air level monitoring did take place.
          Tegeris & Balster (1994) evaluated the acute behavioural effects in mice of a 20-
          min inhalation exposure to 2000, 4000 and 8000 ppm benzene and five derivatives
          (toluene, ethyl benzene, propyl benzene, m-xylene and cumene). All six chemicals
          produced a nearly identical profile of CNS depressant effects that paralleled those
          of the anaesthetic drug pentobarbital, except that they were short-lived, with
          recovery beginning within minutes of cessation of exposure.
          In mice, administration for 4 weeks of 8-180 mg/kg/day benzene in drinking water
          had no behavioural effects, but induced a dose-related increase in the level of
          noradrenaline, dopamine, serotonin and their metabolites in a number of brain
          regions (Hsieh et al, 1988b). There was also a dose-dependent stimulation of
          hypothalamic-pituitary-adrenocortical activity (Hsieh et al, 1991). Changes in brain
          noradrenaline, dopamine, serotonin and/or their metabolites were also found in rats
          2 h after a single oral dose of 950 mg/kg benzene or following inhalation of 1500
          ppm benzene, 6 h per day for 3 days (Andersson et al, 1983; Kanada et al, 1994).
          The most consistent finding in these studies was an increase in noradrenaline and
          dopamine levels in the hypothalamus and other subcortical brain regions. In a rat
          inhalation study, benzene also induced noradrenaline release from post-ganglionic
          sympathetic nerves in the ovaries and uterus (Ungváry & Donáth, 1984).
          A 30-day drinking water study found a reduction in brain weight in mice at 350 but
          not at 195 mg/kg/day (Shell 1992, as cited in ATSDR, 1997). No studies were
          identified that specifically looked for benzene-induced morphological changes in
          nervous organs or tissues.

          Immunotoxicity

          When administered to mice by inhalation or in drinking water, benzene suppressed
          a number of lymphocyte (LC) functions. These included T- and B-LC response to
          mitogens; interleukin-2 production in T-helper LC; the activity of cytotoxic,
          alloreactive and suppressive T-LC; B-LC antibody production; and T-LC and
          macrophage resistance to intracellular infection with Listeria monocytogenes (Fan,
          1992, as cited in USEPA, 1998c; Hsieh et al, 1988a; Irons et al, 1983; Rosenthal &
          Snyder, 1985, 1987; Rozen et al, 1984; Rozen & Snyder, 1985; Stoner et al, 1981,
          as cited in IPCS, 1993; White et al, 1984, as cited in USEPA, 1998c). Based on the
          above effects, the lowest observed adverse effect level (LOAEL) was 10 ppm by
          inhalation (Rozen et al, 1984) and 12 mg/kg/day by the oral route (White et al,
          1984, as cited in USEPA, 1998c). A no observed adverse effect level (NOAEL)
          was not achieved, although Hsieh et al. (1988a) found a bimodal response with a
          reduction in LC proliferation at 40 mg/kg/day and an increase at 8 mg/kg/day, the
          lowest dose tested. However, Daiker et al. (2000) recently found no changes in
          spleen LC cellularity, subtype profile or function in mice exposed to inhalation of
          0.44 ppm benzene for 7 h/day, 5 days/week for 6 weeks.
          In these studies in mice, immunosuppression generally occurred at exposure levels
          which were also associated with reduced absolute lymphocyte counts (ALC).
          However, in one 30-day study, mitogen-stimulated LC proliferation was decreased
          at 12 mg/kg/day (the lowest dose tested) in the absence of any other blood or bone
          marrow toxicity (White et al, 1982, as cited in USEPA, 1998c). There is no
Benzene                                       53

evidence of specificity with respect to antigen or immune response type. Overall,
these findings indicate that benzene-induced immunosuppression is the outcome of
a general impairment of the ability of LC to respond to antigenic stimuli by rapid
clonal expansion, with little, if any, interference with antigen recognition.
In wild cotton rats given three consecutive intraperitoneal injections of benzene at a
dosage of 0, 100, 300, 600 or 1000 mg/kg/day and a battery of tests for cellular and
humoral immune functions on days 1-9 after the last treatment, there was no
evidence of immunosuppression in any of the treatment groups (McMurry et al,
1991).
In a subacute inhalation study in male Sprague-Dawley rats exposed to 0, 30, 200
or 400 ppm benzene for 6 h/day, 5 days/week for 2-4 weeks, Robinson et al. (1997)
determined a NOAEL/LOAEL of 200/400 ppm based on spleen weight, cellularity,
total T-LC, T-helper LC, antigen-stimulated and unstimulated B-LC content, and
thymus weight. As such, rats appear to be less sensitive than mice to the
immunotoxic effects of benzene.

Effects on blood and blood forming organs

ATSDR (1997) and USEPA (1998c) have reviewed a large number of published
and unpublished study reports that address the effects of short-term exposure to
benzene on the blood and blood forming organs of mice and rats. Based on these
reviews, the overall findings can be summarised as follows:
     In peripheral blood, there was a decrease in the quantity of some or all of the
·
     formed elements, including red blood cells (RBC), white blood cells (WBC),
     LC and blood platelets (Plt). In some studies, there was also a reduction in
     haemoglobin (Hb) levels and the average RBC size (mean corpuscular volume
     (MCV)) was either increased or decreased.
     There was bone marrow hypoplasia, with decreased numbers of multipotential
·
     stem cells and cells that differentiate into RBC, WBC and macrophages, but an
     increase in immature RBC such a micronucleated polychromatic and
     normochromatic RBC.
     In the spleen, there was a decrease in the number of all LC types, but an
·
     increase in haematopoiesis in general3.
     There was a decrease in the weight of the thymus, which is the main site of T-
·
     LC proliferation.
The order of susceptibility to these effects was male mice > female mice > rats. In
terms of target organ, it was spleen  peripheral blood  bone marrow > thymus. In
mice, the most sensitive indicators of benzene toxicity were spleen weight, bone
marrow cellularity, and WBC and RBC counts, one or more of which were affected
at concentrations around 10 ppm and above for inhalation and at 8 mg/kg/day and
above for oral exposure. In rats, the most sensitive end points were ALC and WBC
counts, which were affected at 100 ppm by inhalation and 25 mg/kg/day by oral
administration.




3
  Haematopoiesis is the sum of processes involved in the production and development of the blood
cells. The haematopoietic processes are usually confined to the bone marrow, but may also take place
in the spleen and liver, for example, in foetuses and newborn animals, or when there is a substantial
increase in the demand for blood cells.
                                                                  Priority Existing Chemical Number 21
                                            54

          Two 2-16 week studies in the mouse showed that all haematological abnormalities
          returned to normal or near-normal within 4-25 weeks post-exposure (Cronkite et al,
          1985; Snyder et al, 1988).

          Other effects

          There are no consistent reports of respiratory, cardiovascular, gastro-intestinal,
          hepatic or renal effects of short-term exposure to benzene by any route (ATSDR,
          1997). Effects on reproductive organs are reviewed in Section 10.5. Mortality was
          generally low and only a few studies reported decreases in body weight (BW) gain.

          Other experimental animals

          There is limited evidence that airborne exposure to benzene for 3-4 weeks induces
          leukopoenia in guinea pigs and lymphocytopoenia, leukopoenia and impaired
          cellular immunity in pigs at levels 88-100 ppm (Dow, 1982, as cited in ATSDR,
          1997; Wolf et al, 1956).

10.4.2 Long-term exposure

          Blood and blood forming organs

          ATSDR (1997) and USEPA (1998c) have reviewed more than a dozen published
          reports which describe the results of nine separate studies of the long-term effects
          of benzene exposure on blood and blood forming organs. In these studies, mice or
          rats were exposed to benzene for 26 weeks by oral administration in vegetable oil
          or by whole-body inhalation for 5-6 h/day, 4-5 days/week, at dose levels ranging
          from 1-500 mg/kg/day by mouth and from 88-300 ppm by inhalation.
          The most consistent long-term effect on the blood was a reduction in RBC, WBC
          and LC counts. In some studies, the number of neutrophilic granulocytes and
          reticulocytes (young RBC) was increased. The bone marrow and the spleen showed
          hypoplasia in some studies and an increase in haematopoietic tissue in others.
          Haematological effects were recorded at the lowest dose level examined in all long-
          term tests, except for one poorly reported rat study in which the NOAEL was 1
          mg/kg/day by mouth (Wolf et al, 1956). This study also recorded a lower LOAEL
          than any of the other available studies, namely 88 ppm by inhalation based on
          WBC count and spleen weight and 10 mg/kg/day by oral administration based on
          WBC count. In more adequately reported studies, the LOAEL was 100 ppm by
          inhalation and 25 mg/kg/day by mouth in both mice and rats (ATSDR, 1997;
          USEPA, 1998c).

          Other effects

          There are no consistent reports of non-neoplastic cardiovascular, liver or kidney
          abnormalities from long-term exposure to benzene by any route (ATSDR, 1997).
          There was chronic irritation of the forestomach epithelium in male rats and mice
          and hyperplasia of the Harderian gland4 and pulmonary alveolar epithelium in male
          and female mice in 2-year, but not in 17-week oral gavage studies (NTP, 19865).
          Lesions occurred at 200 mg/kg/day in rats and at dose levels 25 mg/kg/day in


          4
           A tear gland in the median angle of the eye which is rudimentary in humans.
          5
           The major findings in the studies conducted by the National Toxicology Program (NTP) have been
          published by Huff et al. (1989).
Benzene                                            55

       mice. Reproductive effects are described below. The median survival time and BW
       gain were generally reduced in a dose-dependent manner.

       Other experimental animals

       There is limited evidence that airborne exposure to benzene for 35-38 weeks
       induces leukopoenia and increased spleen weight in guinea pigs and leukopoenia in
       rabbits at dose levels 80-88 ppm (Wolf et al, 1956).

10.5   Reproductive toxicity

10.5.1 Effects on fertility and lactation
       Data on fertility and lactation are available from three repeated-dose toxicity tests,
       three one-generation fertility studies and a limited number of other studies.

       Repeated-dose toxicity and one-generation fertility studies

       In a 13-week inhalation study, Ward et al. (1985) exposed groups of 150 mice and
       50 rats per sex to inhalation of 0, 1, 10, 30 or 300 ppm benzene for 6 h/day, 5
       days/week. There was clear evidence of haematological toxicity at the highest dose
       level in both species and sexes, but no consistent exposure-related trends in
       mortality, clinical observations or mean BW data. The testes and ovaries from 20
       mice/sex/group and from 10 rats/sex exposed to either 0 or 300 ppm benzene were
       examined microscopically. In mice from the highest exposure group (300 ppm),
       there were 4 animals with cystic ovaries, 7 with bilateral testicular atrophy or
       degeneration, 6 with decreases in the number of spermatozoa in the epididymal
       ducts and 9 with an increase in abnormal sperm forms. Similar lesions of doubtful
       biological significance were seen in both sexes at lower dose levels. No
       abnormalities were found in the gonads of rats exposed to 300 ppm benzene.
       A study in mice administered benzene at 25, 50 or 100 mg/kg/day by gavage for 2
       years found the following number of animals with epithelial hyperplasia or
       follicular atrophy of the ovaries (NTP, 1986):
        Ovarian lesions:         0 mg/kg/day    25 mg/kg/day   50 mg/kg/day       100 mg/kg/day
        No. of mice examined         47              44              49                  48
        Epithelial hyperplasia       12              39              31                  29
        Senile atrophy               15              35              32                  22

       The statistical significance of these findings is not reported. However, when
       analysed for this assessment, the increase in the incidence of epithelial hyperplasia
       was significant at all dose levels, whereas the incidence of senile atrophy was
       significantly elevated at 25 and 50, but not at 100 mg/kg/day (p <0.05; test for
       exact confidence limits). Testes were not examined microscopically, as they had no
       grossly visible lesions. A parallel study in rats found no macroscopic abnormalities
       in the gonads, even at the highest dose level tested (100 mg/kg/day in females, 200
       mg/kg/day in males) (NTP, 1986).
       In an early inhalation study, Wolf et al. (1956) observed sedation, growth
       depression, mortality and a moderate increase in testis weight in male rats exposed
       to 6600 ppm benzene for 13 weeks. The testes were normal in rats exposed to 88 or
       2200 ppm for 30 weeks. At these dose levels there were mild lesions of the blood
       and lymphatic system, but no mortality. In guinea pigs and rabbits exposed to 80-
       88 ppm benzene for 35-38 weeks, there was no mortality, mild haematological
                                                                Priority Existing Chemical Number 21
                                               56

          changes and a slight increase in testis weight and in mild degenerative lesions of
          the seminiferous tubules. Further details were not reported and it is unclear whether
          these findings were statistically significant.
          In female mice, a single intraperitoneal injection of benzene at the maximum
          tolerated dose of 1250 mg/kg did not reduce the number of offspring and litters
          produced in a reproductive capacity test involving the observation of 35 treated and
          untreated breeding pairs for 347 days (Bishop et al, 1997).
          In a one-generation fertility study, groups of 26 female rats were exposed to 0, 1,
          10, 30 or 300 ppm for 6 h/day, 5 days/week for 10 weeks prior to mating and then
          daily on days 0-20 of gestation and days 5-20 of lactation (Kuna et al, 1992). In the
          dams, there was no exposure-related effect on BW gain, clinical observations or
          necropsy findings and no fertility-related effects. When the neonates were
          examined at weaning on day 21 postpartum, there was a dose-related, 6-9%
          increase in relative kidney weight in female offspring of dams exposed at 10 ppm
          and above. Female offspring of dams exposed to 300 ppm benzene also had a 10%
          BW reduction and a 14% reduction in absolute liver weight.
          In another fertility study, female rats were kept in inhalation chambers where they
          were exposed for 24 h/day to 0, 0.3, 1.6, 6.3, 15, 18, 20 or 200 ppm benzene
          (Gofmekler, 1968). Exposure began 10-15 days prior to mating, when males were
          introduced into the chambers for 6-10 days, and continued throughout the entire
          pregnancy period until spontaneous delivery. There were no pregnancies at the
          highest dose level. In dams exposed to 0.3-20 ppm benzene, the average litter size
          was 7.5 compared to 8.4 in the controls, but there was no exposure-related effect on
          the birth weight of the pups.

          Other studies

          In early experimental studies, benzene caused degenerative changes in the testes
          and severely hypoplastic ovaries, degenerated ovarian follicles and chromosomal
          damage and mitotic interruption in the ova when administered by subcutaneous
          injection or inhalation to male and female mice and female rabbits (Hett & Mark,
          1938; Vara & Kinnunen, 1946). The dose levels used in mice were not given, but
          were high enough to induce marked leukopoenia. Rabbits were administered 1000
          mg/kg/day for 10 days.
          In a study in adult mice, testicular germ cell suspensions were examined for DNA
          content by flow cytometry at 1, 2, 3, 4 and 10 weeks after a single sublethal dose of
          1-7 mL (880-6160 mg) benzene/kg administered by oral gavage (Spanò et al,
          1989). These doses had no effect on body or testis weight, but resulted in a dose-
          dependent reduction in the relative cell count in the primary spermatocyte and
          spermatid fractions. The primary spermatocyte fraction was most affected at 2
          weeks, the round spermatid fraction at 3 weeks and the elongated spermatid
          fraction at 4 weeks post-treatment, as one would expect from a cytotoxic insult
          resulting in a transient reduction in the number of differentiating spermatogonia.

          Conclusions

          Overall, the above studies indicate that benzene exposure may cause degenerative
          changes in the gonads of mice, whereas there is insufficient evidence of similar
          effects in other species. There was also epithelial hyperplasia in the ovaries of mice
          in the NTP (1986) 2-year oral bioassay. However, this is likely to represent a
          preneoplastic lesion as ovarian tumours occurred with a significant positive trend in

Benzene                                        57

       this study and epithelial hyperplasia was found in other organs with neoplastic
       lesions, namely the Harderian gland and the lungs.
       Compound-related testicular atrophy or degeneration was observed in male mice
       exposed to 300 ppm benzene by inhalation. Ovarian atrophy was observed in mice
       at 25 mg/kg/day by mouth and cystic ovaries at 300 ppm by inhalation. In both
       sexes, these lesions occurred at dose levels that were associated with
       haematological effects, but not with mortality or other signs of generalised toxicity.
       The available data on reproductive capacity are inconclusive.
       The changes in body, liver and relative kidney weights observed by Kuna et al.
       (1992) in 21-day old female neonates of rats exposed to inhalation of benzene
       during pregnancy and lactation are modest, but nonetheless indicative of
       developmental toxicity. Because of the study design it cannot be determined
       whether these effects were lactational or the result of exposure in utero.

10.5.2 Developmental toxicity

       Standard tests

       Developmental toxicity tests have been conducted in mice, rats and rabbits exposed
       to benzene by inhalation, mouth or subcutaneous injection during the gestation
       period (Table 10.2). All foetuses were examined for external defects and in all but
       two studies (Exxon Chemical Company, 1986, as cited in USEPA, 1998c;
       Watanabe & Yoshida, 1970) for visceral and skeletal abnormalities as well.
       Overall, there were no major structural abnormalities in the foetuses, except in one
       study in the mouse in which a single SC injection of a maternally toxic dose of
       2600 mg/kg benzene on GD 13 was associated with cleft palate and jaw
       malformations (Watanabe & Yoshida, 1970). However, several inhalation and oral
       studies conducted in mice or rats found evidence of other foetal effects at dose
       levels where no toxic effects were recorded in the dams. These include a small (4-
       6%), but statistically significant reduction in foetal BW (Coate et al, 1984; Murray
       et al, 1979; Seidenberg et al, 1986) and a significant increase in the frequency of
       minor skeletal abnormalities (Green et al, 1978; Murray et al, 1979). Moreover, in
       two studies on which little experimental detail is available, there was an increase in
       resorptions in rats (Litton Bionetics, 1977, as cited in USEPA, 1998c) and a
       decrease in foetal BW in mice (Nawrot & Staples, 1979), in both cases in the
       absence of any signs of maternal toxicity.
       In rabbits, continuous inhalation of 310 ppm benzene was associated with
       abortions, an increase in resorptions or foetal deaths, a decrease in foetal BW and
       an increased incidence of minor abnormalities in the presence of maternal toxicity
       (reduced BW gain), whereas 155 ppm had neither foetal nor maternal effects
       (Ungváry & Tátrai, 1985).




                                                               Priority Existing Chemical Number 21
                                            58

           Table 10.2: Summary of developmental toxicity tests*
                                                                                                                                 
          Species   Study design                   Daily dose   Foetal effects                                 Maternal effects                 Reference




Benzene
                                                                None                                           Decreased Hgb
          Mouse     SC injection on GD 8-9 or GD 1760 mg/kg                                                                                     Matsumoto et al.
                    12-13                                                                                                                       (1975)
                                                                Decreased BW (3%)                              Decreased Hgb
                    8-11 pregnancies per group     3520 mg/kg
                                                                Decreased placenta weight (5%) in GD 12-       Decreased WBC count
                                                                13 group
                                                                Delayed ossification in GD 12-13 group

                    Inhalation, 7 h/day, GD 6-15   500 ppm      Decreased BW (6%)                              None                             Murray et al.
                    26-30 pregnancies/group                     Unspecified increase in `minor skeletal                                         (1979)
                                                                variants'

                    Oral gavage 3 times daily,     800 mg/kg    Decreased BW                                   None                             Nawrot &
                    GD 6-15                                                                                                                     Staples (1979)
                                                   1300 mg/kg   Increase in resorptions                        Increase in mortality
                    No. of pregnancies not given
                                                                Decreased BW
                                                   2600 mg/kg   Increase in resorptions                        Increase in mortality
                                                                Decreased BW




59
                                                   2600 mg/kg   Increase in late resorptions                   Increase in mortality
                    Oral gavage 3 times                                                                                                         Nawrot &
                                                                Decreased BW
                    daily,GD 12-15                                                                                                              Staples (1979)
                    No. of pregnancies not given

                                                   155 ppm                                                     No information
                                                                `Weight retardation' (25 vs. 7% of foetuses)
                    Inhalation, 24 h/day, GD 6-                                                                                                 Ungváry & Tátrai
                                                                Delayed ossification (10 vs. 5% of foetuses)
                    15                                                                                                                          (1985)
                    15 exposed pregnancies
                    115 control pregnancies        310 ppm                                                     No information
                                                                `Weight retardation' (27 vs. 7% of foetuses)
                                                                Delayed ossification (11 vs. 5% of foetuses)

                                                   1300 mg/kg                                                  None
                    Oral gavage, GD 8-12                        Decreased BW (4%)                                                               Seidenberg et al.
                    28 pregnancies/group                                                                                                        (1986)

                                                   2600 mg/kg                                                  Decrease in WBC count in all
                    Single SC injection on GD                                                                                                   Watanabe &
                                                                Increased incidence of cleft palate and jaw
                                                                                                               dams
                    11, 12, 13, 14 or 15                                                                                                        Yoshida (1970)
                                                                malformations in offspring of dams injected
                                                                                                               No difference in fall in WBC
                    15 pregnancies per group                    on GD 13 compared to foetuses of dams
                                                                                                               count or in BW gain between
                    No controls                                 injected on GD 11-12 or 14-15
                                                                                                               dams with or without malformed
                    External foetal examination
                                                                                                               foetuses
                    only

                                        Table 10.2: Continued
                                                                                                                                                              
                                       Species   Study design                   Daily dose   Foetal effects                                 Maternal effects                        Reference

                                       Rat       Inhalation, 6 h/day, GD 6-15   10 ppm                                                                                              Litton Bionetics
                                                                                             Increase in resorptions                        None
                                                                                                                                                                                    (1977), as cited
                                                 26-31 pregnancies/group
                                                                                                                                                                                    in EPA (1998c)
                                                                                40 ppm       Increase in resorptions                        None
                                                                                                                                                                                    Green et al.
                                                                                                                                            None
                                                                                100 ppm      Missing sternebrae (9/18 vs. 1/16 litters)
                                                 Inhalation, 7 h/day, GD 6-15
                                                                                                                                                                                    (1978)
                                                 14-18 pregnancies/group
                                                                                                                                            None
                                                                                300 ppm      Delayed ossification of sternebrae (10 vs.
                                                                                             2% of female foetuses)
                                                                                             Decreased BW (10%)                             Decreased BW gain
                                                                                2200 ppm
                                                                                             Decreased crown-rump length (5%)               Lethargy
                                                                                             Delayed ossification of sternebrae (11 vs.
                                                                                             1% of female foetuses)
                                                                                             Missing sternebrae (11/15 vs. 2/14 litters)

                                                                                             Decreased BW (12%)                                                                     Hudák &
                                                                                                                                            Decreased BW gain (57%)
                                                                                313 ppm
                                                 Inhalation, 24 h/day, GD 9-
                                                                                             Delayed ossification (11 vs. 0% of foetuses)                                           Ungváry (1978)
                                                 14
                                                                                             Fused sternebrae and extra ribs (9 vs. 1% of
                                                 19 exposed pregnancies




  60
                                                                                             foetuses)
                                                 28 controls
                                                                                             Decreased BW (5%)                                                                      Tátrai et al.
                                                 Inhalation, 24 h/day, GD 7-                                                                Decreased BW gain (27%)
                                                                                50 ppm
                                                                                                                                                                                    (1980)
                                                 14                                                                                         Decreased placenta weight (9%)
                                                 17-20 pregnancies/
                                                                                             Resorbed or dead foetuses (42 vs. 6%)          Mortality (3/20 vs. 0/48)
                                                                                150 ppm
                                                 exposure group
                                                                                             Decreased BW (28%)                             Decreased BW gain (45%)
                                                 46 control pregnancies
                                                                                             Skeletal abnormalities (57 vs. 5% of           Increased relative liver weight (9%)
                                                                                             foetuses)                                      Decreased placenta weight (7%)


                                                                                             Resorbed or dead foetuses (32 vs. 6%)          Mortality (1/22 vs. 0/48)
                                                                                500 ppm
                                                                                             Decreased BW (20%)                             Decreased BW gain (55%)
                                                                                             Skeletal abnormalities (66 vs. 5% of           Increased relative liver weight (14%)
                                                                                             foetuses)                                      Decreased placenta weight (16%)


                                                                                             Resorbed or dead foetuses (29 vs. 6%)          Mortality (3/22 vs. 0/48)
                                                                                1000 ppm
                                                                                             Decreased BW (22%)                             Decreased BW gain (41%)




Priority Existing Chemical Number 21
                                                                                             Skeletal abnormalities (55 vs. 5% of           Increased relative liver weight (10%)
                                                                                             foetuses)                                      Decreased placenta weight (20%)

           Table 10.2: Continued
                                                                                                                                                    
          Species        Study design                        Daily dose        Foetal effects                                       Maternal effects                       Reference

          Rat            Inhalation, 7 h/day, GD 6-15       10 ppm                                                                                                         Kuna & Kapp
                                                                              None                                                 Increased BW gain (33%) on GD 15-




Benzene
                         14-15 pregnancies/                                                                                                                                (1981)
                                                                                                                                   20
                         exposure group
                                                                                                                                   Decreased BW gain (34%) on GD 5-
                                                            50 ppm             Decreased BW (14%)
                         11 control pregnancies
                                                                                                                                   15
                                                                              Increase in foetuses with skeletal and/or
                                                                              visceral variations (18 vs. 3%)

                                                                                                                                   Decreased BW gain (37%) on
                                                            500 ppm            Decreased BW (18%)
                                                                                                                                   GD 5-15
                                                                              Decreased crown-rump length (7%)
                                                                                                                                   Increased BW gain (40%) on GD 15-
                                                                              Increase in foetuses with skeletal and/or
                                                                                                                                   20
                                                                              visceral variations (21 vs. 3%)
                                                                                                                                                                           Coate et al.
                                                                                                                                   None
                         Inhalation, 7 h/day, GD 6-15       1 ppm             None
                                                                                                                                                                           (1984)
                         32-38 pregnancies/group
                                                                                                                                   None
                         2 control groups                   10 ppm            None

                                                                                                                                   None
                                                            40 ppm            None

                                                                                                                                   None
                                                            100 ppm           Decreased BW (6%)




61
                                                                                                                                                                           Exxon Chemical
                                                                                                                                   None
                         Oral gavage, GD 6-15               50 mg/kg          None
                                                                                                                                                                           Company
                         20-22 pregnancies/group
                                                                                                                                                                           (1986), as cited
                                                                                                                                   Decreased feed consumption
                                                            250 mg/kg
                         External foetal examination                          None
                                                                                                                                                                           in EPA (1998c)
                         only
                                                                                                                                   Decreased BW gain
                                                            500 mg/kg         Decreased BW
                                                                                                                                   Decreased feed consumption
                                                                                                                                   Decreased BW gain
                                                            1000 mg/kg        Decreased BW
                                                                                                                                   Decreased feed consumption
                                                                                                                                   Alopecia
                                                            500 ppm
          Rabbit                                                                                                                                                           Murray et al.
                                                                              None
                         Inhalation, 7 h/day, GD 6-18                                                                              Increased feed and water
                                                                                                                                                                           (1979)
                         18-19 pregnancies/group                                                                                   consumption
                                                                                                                                                                           Ungváry & Tátrai
                         Inhalation, 24 h/day, GD 7-20 155 ppm                None                                                 None
                                                                                                                                                                           (1985)
                         11-15 exposed pregnancies/
                         group                         310 ppm                 Abortions (6/15 vs. 0/60 dams)                       Decreased BW gain (62%; not
                                                                               Resorbed or dead foetuses (16 vs. 5%)                corrected for the effect of
                         60 control pregnancies
                                                                               Decreased BW (17%)                                   abortions)
                                                                              `Minor anomalies' (86 vs. 34% of foetuses)           Increased relative liver weight (17%)

          * BW = body weight; GD = gestation day; Hgb = haemoglobin; SC = subcutaneous; WBC = white blood cell.
          
            Where available, information on the incidence or magnitude of effects compared to non-exposed controls is shown in brackets.

Other studies

According to Ungváry (1985), continuous inhalation of benzene (125 ppm),
benzene plus toluene, or benzene plus xylenes had foetotoxic effects in rats, but
only in the presence of maternal toxicity. Exposure to 830 ppm benzene over 48 h
on GD 10-13 increased the severity of maternal toxicity and incidence of
malformations induced by a single oral dose of 250-500 mg/kg acetyl salicylic acid
administered at the end of the exposure period.
Keller & Snyder (1986, 1988) investigated the effects of low level maternal
exposure to benzene on the blood and blood forming organs of mouse foetuses,
neonates and young adults. Groups of 5-10 dams were exposed to inhalation of 0,
5, 10, or 20 ppm benzene for 6 h/day on GD 6-15. Tests on the progeny comprised
RBC, WBC, differential blood cell count, and blood cell morphology; Hb and
haematocrit (Hct); quantification of colony forming units of erythrocyte (CFU-E)
and granulocyte/macrophage (CFU-GM) progenitor cells; and microscopic
examination of blood forming tissue in the liver, bone marrow and spleen. The
number of progeny examined included 2/sex/litter/dose on GD 16, 2/sex/litter/dose
on day 2 after birth, and 1/sex/ litter/dose at 6 weeks after birth.
In 16-day old foetuses exposed to 20 ppm benzene in utero, liver CFU-E was
depressed in both sexes. In peripheral blood from the 2-day old neonates, there was
a dose-related, marked decrease in the number of nucleated RBC. At 20 ppm, there
was also an increase in CFU-E (males only), CFU-GM, non-dividing and dividing
granulocytes in hematopoietic liver tissue, and in non-dividing granulocytes in
peripheral blood. In 6-week old young adult progeny, bone marrow CFU-E was
depressed and spleen CFU-E increased in males exposed to 10 but not to 20 ppm in
utero. In the 20 ppm group, there was a decrease in early nucleated RBC in the
bone marrow and an increase in blast cells in the spleen. There were no effects on
BW or BW gain, feed consumption and clinical signs in the dams, or on BW and
structural abnormalities in the foetuses at any dose level.
In a subsequent study on the interaction between alcohol and inhaled benzene in
mice, CFU-E was significantly depressed in the liver of 16-day old male (but not
female) foetuses exposed in utero to 10 ppm benzene for 6 h/day on GD 6-15
(Corti & Snyder, 1996). This study comprised a total of 9 exposed and 12 control
litters.
The embryotoxicity of benzene and its major metabolites has also been investigated
in vitro in GD 10-12 rat conceptuses. There were no toxic effects at concentrations
of 0.4-0.8 mM (32-64 mg/L) benzene (Brown-Woodman et al, 1994; Chapman et
al, 1994). Phenol was not toxic at 1.6 mM, but caused 100% lethality at 0.2 mM in
the presence of several CP450-dependent bioactivating systems. In the absence of
metabolic activation, catechol, hydroquinone, and quionone each produced 100%
lethality at 0.1 mM and the combination of phenol and hydroquinone showed a
greater than additive effect (Chapman et al, 1994).

Conclusions

In several studies in pregnant animals exposed to benzene by inhalation or
ingestion, there was a small, but statistically significant decrease in foetal BW and
an increase in the incidence of minor skeletal abnormalities at dose levels at which
there was no evidence of maternal toxicity. Major structural abnormalities and
abortions only occurred at dose levels that also caused marked toxicity in the dams.
As such, benzene can be characterised as foetotoxic, but not teratogenic. Based on

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          adequately reported rat studies that found foetal effects in the absence of any signs
          of maternal toxicity, the inhalation NOAEL for foetal growth disturbances is 40
          ppm (Coate et al, 1984), with a LOAEL of 100 ppm (Coate et al, 1984; Green et al,
          1978). Reliable oral effect levels cannot be determined from the available data.
          In a small number of pregnant mice, inhalation of 10-20 ppm benzene resulted in
          specific adverse effects on multipotential haematopoietic stem cells (colony
          forming units) and other blood cells in the liver, bone marrow or spleen of the
          offspring (Corti & Snyder, 1996; Keller & Snyder, 1986, 1988). These effects
          occurred in the absence of any other signs of developmental toxicity and at levels
          similar to those that are known to be toxic to the blood and blood forming organs of
          adult mice (Section 10.4).
          In vitro studies indicate that some benzene metabolites, including catechol,
          hydroquinone and quinone (but not phenol) are substantially more toxic to rat
          embryos than benzene itself.

10.6      Genotoxicity
          The toxic effects of benzene on human genetic material have been investigated in
          numerous in vivo studies which are addressed in Section 11.6 below. As such, the
          assessment of studies conducted in animals and various in vitro systems is limited
          to an overview of the most significant findings. Unless otherwise indicated, the
          information presented is summarised from ATSDR (1997), IARC (1987), IPCS
          (1993) and USEPA (1998a).

          In vitro tests

          Tests with benzene itself have predominantly produced negative results in
          conventional in vitro gene mutation assays in bacteria and mammalian cell systems,
          with and without metabolic activation. In vitro assays for chromosome aberrations
          have also generally been negative, unless special precautions were taken to prevent
          the evaporation of benzene from the test system (Randall et al, 1993). Likewise,
          conventional in vitro tests for DNA breaks, unscheduled DNA synthesis and DNA
          synthesis inhibition have produced inconsistent results. However, sister chromatid
          exchanges (SCE), micronuclei (MN) and unscheduled DNA synthesis have been
          induced in vitro by metabolites such as catechol, hydroquinone and/or quinone, and
          DNA adducts with phenol, hydroquinone and quinone have been detected in a
          number of in vitro systems. Benzene itself has recently been shown to induce
          morphological transformation, gene mutations through base substitutions, and
          aneuploidy in Syrian hamster embryo cells, but is less potent than its metabolites
          (Tsutsui et al, 1997). In the alkaline single cell gel electrophoresis (Comet) assay,
          pronounced, contact time-dependent DNA damage has been detected in non-
          cycling (G0) human LC after treatment not only with catechol, hydroquinone,
          quinone, 1,2,4-trihydroxybenzene or muconic acid, but also with benzene itself
          (Anderson et al, 1995).

          Tests in Drosophila

          Benzene was consistently negative in the sex-linked recessive lethal test in
          Drosophila melanogaster, which is a specific, but insensitive test for the potential
          of chemicals to cause heritable gene mutations and chromosome aberrations.
          However, benzene has been shown to induce a statistically significant number of


Benzene                                        63

       so-called delayed lethal mutations, which may be the result of heritable mutations
       in one rather than in both DNA strands of the X chromosome (Kale & Kale, 1995).

       In vivo tests in rodents

       There is ample evidence that benzene is genotoxic in a broad spectrum of in vivo
       tests in rodents, in which the chemical was administered by inhalation, oral gavage
       or parenteral injection. These include tests for SCE and MN induction in peripheral
       blood cells, bone marrow cells, foetal liver cells, lung fibroblasts (Ranaldi et al,
       1998), and Zymbal gland cells (Angelsanto et al, 1996); gene mutations in LC, lung
       and spleen cells; chromosome aberrations in LC, bone marrow cells, spleen cells,
       and spermatogonia; and DNA adducts in nucleated blood and bone marrow cells.
       Furthermore, many of these effects have been shown to be mitigated by inhibitors
       of benzene metabolism and reproduced by benzene metabolites such as
       hydroquinone and 1,2,4-trihydroxybenzene.
       In an in vivo chromosome aberration study in male mice, the sensitivity and dose
       response to a single oral dose of benzene was found to differ markedly between
       bone marrow cells and differentiating spermatogonia, as illustrated in Figure 10.1
       (Ciranni et al, 1991).

       Figure 10.1: Chromatid aberrations excluding gaps in mouse bone marrow
       cells (broken lines) and spermatogonia (solid lines) at 6-48 h after oral
       treatment with 880 mg/kg benzene (left) and at 24 h after oral treatment with
       88, 220, 440 or 880 mg/kg benzene (right) (Ciranni et al, 1991)



                                  25                                       25
        Per cent aberrant cells




                                  20                                       20


                                  15                                       15


                                  10                                       10


                                   5                                       5


                                   0                                       0
                                                                                0   200      400    600   800   1000
                                       0   6   12 18 24 30 36 42 48
                                                                                           Dose (mg/kg)
                                                 T i m e (h )



       Sensitivity to SCE and MN induction was 2- to 3-fold higher in male than in
       female mice and male sensitivity to MN induction was markedly decreased by
       castration and restored by testosterone treatment (Luke et al, 1988, as cited in
       USEPA, 1998c). Immature mice showed no gender difference in sensitivity to MN
       induction (Siou & Conan, 1980, as cited in USEPA, 1998c).

10.7   Carcinogenicity
       Table 10.3 highlights the principal findings in the 23 carcinogenicity tests that have
       been reported in the open literature. They include oral gavage studies in B6C3F1,
       RF/J and Swiss mice and F344, Sprague-Dawley and Wistar rats and inhalation
       studies in AKR, C57BL, CBA, CD-1 and HRS mice and Sprague-Dawley rats.




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          Table 10.3: Principal findings in inhalation (I) and oral gavage (O)
          carcinogenicity studies in mice and rats

          Strain   I/O Protocol                            Principal findings*                   Reference
          Mice
          AKR                                              No increase in tumour incidence
                    I                                                                            Snyder et al.
                        0, 100 ppm for 6 h/day, 5
                                                                                                 (1980)
                        days/week for life (72 weeks)
                    I                                      No increase in tumour incidence
                        0, 300 ppm for 6 h/day, 5                                                Snyder et al.
                        days/week for life (28 weeks)                                            (1978)
                   O
          B6C3F1                                                                              NTP (1986)
                        0, 25, 50, 100 mg/kg/day for 5     Harderian gland tumours, lung
                        days/week, 103 weeks               tumours, lymphoma, mammary
                                                           gland carcinoma, ovarian granulosa
                                                           cell and mixed benign tumours,
                                                           preputial gland carcinoma, Zymbal
                                                           gland carcinoma
          C57BL     I   0, 300 ppm 6 h/day, 5              Lymphoma, ovarian tumours,            Cronkite et al.
                        days/week for 16 weeks, with       Zymbal gland carcinoma (no            (1985)
                        life-long observation (about       statistical analysis)
                        110 weeks)
                                                           Lymphoma
                    I                                                                            Snyder et al.
                        0, 300 ppm for 6 h/day, 5
                                                                                                 (1980)
                        days/week for life (70 weeks)
                    I                                      Zymbal gland carcinoma
                        0, 300 ppm 6 h/day, 5                                                    Snyder et al.
                        days/week, 1 out of every 3                                              (1988)
                        weeks for life (118 weeks)
                    I                                      No increase in tumour incidence
                        0, 1200 ppm 6 h/day, 5                                                   Snyder et al.
                        days/week for 10 weeks, with                                             (1988)
                        life-long observation (about
                        146 weeks)
          CBA§      I   0, 100 ppm for 6 h/day, 5          Unspecified, non-hepatic, non-        Cronkite et al.
                        days/week for 16 weeks, with       haematopoietic tumours                (1989)
                        life-long observation (about
                        135 weeks)
                    I   0, 300 ppm for 6 h/day, 5          Non-hepatic, non- haematopoietic      Cronkite et al.
                        days/week for 16 weeks, with       tumours (including Harderian gland    (1989)
                        life-long observation (about       carcinoma, lung adenocarcinoma,
                        115 weeks)                         mammary gland carcinoma,
                                                           neoplasms resembling acute
                                                           myeloblastic and chronic
                                                           granulocytic leukaemia, Zymbal
                                                           gland carcinoma)
                    I   0, 300 ppm for 6 h/day, 5          Lung adenoma, lymphoma,               Farris et al.
                        days/week for 16 weeks, with       preputial gland carcinoma             (1993)
                        life-long observation (78
                        weeks)
          CD-1      I   0, 300 ppm for 6 h/day, 5          Sporadic cases of suspected           Goldstein et al.
                        days/week for life (not further    myeloid leukaemia (p = 0.147)         (1982)
                        specified)
                    I                                      Lung adenoma
                        0, 300 ppm for 6 h/day, 5                                                Snyder et al.
                        days/week 1 out of every 3                                               (1988)
                        weeks for life (about 60
                        weeks)
                    I   0, 1200 ppm for 6 h/day, 5         Lung adenoma, Zymbal gland            Snyder et al.
                        days/week for 10 weeks, with       carcinoma                             (1988)
                        life-long observation (about
                        130 weeks)
          HRS       I   0, 400 ppm for 6 h/day, 5          No leukaemia or lymphoma in either Stoner et al.
                        days/week for 26 weeks                                                (1980), as cited
                                                           hr/hr (leukaemia-prone) or hr/-
                                                                                              in Cronkite et al.
                                                           (leukaemia-resistant) strains
                                                                                              (1985)
          RF/J     O    0, 500 mg/kg/day for 5             Lymphatic neoplasms, lung             Maltoni et al.
                        days/week, 52 weeks                tumours, mammary gland                (1989)
                                                           carcinoma (no statistical analysis)
          Swiss    O    0, 500 mg/kg/day for 5             Lung adenomas, mammary gland      Maltoni et al.
                        days/week, 78 weeks                carcinoma, Zymbal gland carcinoma (1989)
                                                           (no statistical analysis)




Benzene                                               65

Table 10.3: Continued
Strain     I/O   Protocol                         Principal findings                     Reference
Rat
F344        O                                                                            NTP (1986)
                 0, 50, 100, 200 mg/kg/day in     Oral cavity tumours, skin tumours,
                 males and 0, 25, 50, 100         Zymbal gland carcinoma
                 mg/kg/day in females for 5
                 days/week, 103 weeks
                                                  No increase in tumour incidence
            I                                                                            Snyder et al.
                 0, 100 ppm for 6 h/day, 5
Sprague-
                                                                                         (1984)
                 days/week for life (123
Dawley
                 weeks)
            I                                     No increase in tumour incidence
                 0, 300 ppm for 6 h/day, 5                                               Snyder et al.
                                                                                         (1978)
                 days/week for life (99
                 weeks)
            I    0, 200-300 ppm for 4-7           Oral cavity carcinoma, Zymbal          Maltoni et al.
                 h/day, 5 days/week, 104          gland carcinoma (no statistical        (1989)
                 week                             analysis)
            O    0, 50, 250 mg/kg/day, 5          Mammary gland tumours (lowest          Maltoni et al.
                 days/week, 52 weeks              dose level only), Zymbal gland         (1989)
                                                  carcinoma in females (no statistical
                                                  analysis)
            O    0, 500 mg/kg/day, 5 days/        Forestomach carcinomas, liver       Maltoni et al.
                 week, 104 weeks                  angiosarcomas, nasal and oral       (1989)
                                                  cavity carcinomas, skin carcinomas,
                                                  Zymbal gland carcinoma (no
                                                  statistical analysis)
Wistar      O    0, 500 mg/kg/day, 5              Nasal and oral cavity carcinoma,       Maltoni et al.
                 days/week, 104 weeks             Zymbal gland carcinoma (no             (1989)
                                                  statistical analysis)

* Positive findings were statistically significant (p <0.05) unless otherwise indicated.

  Carries a virus causing spontaneous lymphoma in 90% of animals by 52 weeks of age.

  Carries a virus yielding a high incidence of lymphoma from exposure to radiation, immunosuppression
and certain carcinogens.
§
  Highly susceptible to radiation-induced thymic lymphoma.

There was a frequent association between benzene exposure and the occurrence of
solid tumours in epithelia of the mouth, nasal cavities, lung alveoli, Harderian,
Zymbal, preputial and mammary glands, and the ovary.
With regard to the blood and lymphatic system, the incidence of lymphoma was
elevated in several studies conducted in B6C3F1, C57BL, CBA and RF/J mice.
There was also a statistically significant increase in the incidence of lesions
resembling acute myeloblastic and chronic granulocytic leukaemia in a study in
CBA mice exposed to 300 ppm benzene for 16 weeks (Cronkite et al, 1989). In
addition, 3/40 CD-1 mice exposed to 300 ppm and 1/40 Sprague-Dawley rats
exposed to 100 ppm benzene developed suspected myeloid leukaemia after 27-38
weeks of exposure (Goldstein et al, 1982; Snyder et al, 1984). However, the
increase in lymphoma incidence was limited to strains where this is a common
spontaneous tumour type and the lesions resembling leukaemia may not have been
malignant but rather an intense proliferation of myeloid cells caused by infections
or necrotic processes in benzene-induced tumours in other organs (Farris et al,
1993). Furthermore, early findings of lymphoma or leukaemia-like lesions in a
given strain have not been consistently reproduced in later studies (Farris et al,
1993; Snyder et al, 1988).
Some of the target organs in rodents such as the forestomach, Harderian, Zymbal
and preputial glands have no anatomical equivalent in humans. Moreover, human
exposure to benzene is not associated with tumours of the mouth, nasal cavities or
lung alveoli (see Section 11). However, as there is limited evidence of an elevated
risk of malignant melanoma and breast cancer in humans exposed to benzene-
containing products, skin and mammary tumours are further analysed below.

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          Skin tumours

          The incidence of skin tumours was increased in F344 and Sprague-Dawley rats in
          2-year oral gavage studies (NTP, 1986; Maltoni et al, 1989). By contrast, no skin
          tumours developed in groups of 10 mice after oral, subcutaneous or topical
          application of 800 mg/kg benzene followed 4 weeks later by topical application of
          the tumour promoter 12-o-tetradecanoylphorbol-13-acetate 3 times a week for 20
          weeks (Bull et al, 1986). Furthermore, although benzene was once widely used as a
          solvent in tests for skin cancer induction in mice resulting in large numbers of
          controls being topically exposed to benzene alone, there has been no indication that
          it induced skin tumours in these models (IARC, 1982a).
          In F344 rats, skin tumours were found on the face, back, flank, and other locations.
          Microscopically, they represented a spectrum from pure squamous cell papillomas
          or carcinomas to mixed tumours containing basal cell, sebaceous gland or hair
          follicle elements. By incidental tumour tests, the incidence was elevated in male
          rats at 200 mg/kg/day (12/50 vs. 1/50 in controls; p <0.01), but not at 50 mg/kg/day
          (7/50) or 100 mg/kg/day (5/50), or in female rats treated with 25, 50 or 100
          mg/kg/day. Based on mortality and BW data, high dose male rats were probably
          exposed to benzene levels that exceeded the maximal tolerated dose (NTP, 1986).
          In Sprague-Dawley rats, skin carcinomas (not further specified) occurred in 9/40
          male animals administered 500 mg/kg/day by oral gavage for 2 years. The
          incidence was zero in male controls and treated females (Maltoni et al, 1989). The
          authors did not comment on the statistical significance of these results, however,
          when analysed for this assessment, the difference in incidence between exposed
          and control males was statistically significant (p <0.05; test for exact confidence
          limits). Compared to their controls, male rats had an increased survival rate but a
          reduction in BW that ranged from 6-18% during the course of the study (Maltoni et
          al, 1983).

          Mammary gland tumours

          Mammary tumours have been found in B6C3F1, CBA, RFJ and Swiss mice and
          Sprague-Dawley rats (Cronkite, 1986; NTP, 1986; Maltoni et al, 1989).
          In a 2-year oral bioassay in B6C3F1 mice, benzene induced a significantly elevated
          incidence of carcinomas and carcinosarcomas in mid- and high-dose females, with
          a trend for dose-dependence (Table 10.4). The carcinomas often showed extensive
          squamous cell metaplasia, whereas the carcinosarcomas contained a prominent
          spindle-cell component resembling malignant fibroblasts. The historical incidence
          of mammary gland carcinoma in this strain is approximately 1% (NTP, 1986).
          Table 10.4: Mammary gland lesions in female B6C3F1 mice in a 2-year oral
          carcinogenicity study (NTP, 1986)

          Lesions                    Controls    25 mg/kg/day   50 mg/kg/day   100 mg/kg/day
          Hyperplasia                2/49 (4%)    4/45 (9%)      2/50 (4%)       1/49 (2%)
                                                                                              
          Carcinoma                  0/49 (0%)    2/45 (4%)     5/50 (10%)*     10/49 (20%)
          Carcinosarcoma             0/49 (0%)    0/45 (0%)      1/50 (2%)       4/49 (8%)*

          * p <0.05 (incidental tumour tests).
          
           p <0.01 (incidental tumour tests).

          Among male and female CBA mice exposed to 100 ppm benzene for 6 h/day, 5
          days/week for 16 weeks, 20% had developed mammary gland tumours at follow-up

Benzene                                          67

102 weeks after the last exposure (Cronkite, 1986). Details on tumour incidence in
concurrent or historical controls were not given and the histopathology of the
tumours was not described, although a later publication refers to them as
adenocarcinomas (Cronkite et al, 1989).
In female RF/J mice administered 500 mg/kg/day by oral gavage for 52 weeks, the
incidence of mammary carcinomas was 22.5%, compared to 2.5% in controls. In
female Swiss mice receiving the same treatment for 78 weeks, the incidence was
47.5% compared to 5.0% in controls (Maltoni et al, 1989). The statistical
significance of these findings is not discussed in the paper. When analysed for this
assessment, the incidence in exposed females was significantly different from
controls (p <0.05; test for exact confidence limits) in Swiss but not in RF/J mice.
In female Sprague-Dawley rats given benzene by oral gavage for 1 year, the
incidence of total/malignant mammary tumours was 53.3/13.3% in controls,
73.3/13.3% in animals treated with 50 mg/kg/day, and 45.7/20.0% in animals
treated with 250 mg/kg/day. In female rats given 500 mg/kg/day for 2 years, the
incidence was 32.5/17.5% compared to 42.0/14.0% in controls (Maltoni et al,
1989). The tumours comprised fibroadenomas, adenocarcinomas and carcino-
sarcomas similar to the spontaneous mammary gland tumours commonly found in
ageing female Sprague-Dawley rats (Maltoni et al, 1983). The investigators did not
report on the statistical significance of their findings. When analysed for this
assessment, there was no difference between any of the groups in the incidence of
either total or malignant mammary tumours (p>0.05; test for exact confidence
limits).

Conclusions

The available carcinogenicity studies provide clear evidence of a causal
relationship between benzene exposure and malignant neoplasms in mice and rats.
The tissues most commonly involved are various glandular or non-glandular
epithelia of the oral cavity, nasal cavity, lungs and skin (Table 10.3). The incidence
of lymphoma was increased in several studies, but only in mice where this is a
common spontaneously occurring tumour type. In one study in mice, there was a
significant increase in bone marrow lesions described as resembling myeloblastic
or granulocytic leukaemia (Cronkite et al, 1989), but this may have been the result
of an intense inflammatory response (Farris et al, 1993). As such, a proven
reproducible animal model for benzene-induced leukaemia is not available.
The lowest exposure levels associated with an increase in tumour incidence in
rodents was 100 ppm by inhalation for 16 weeks in CBA mice and 25 mg/kg/day in
a 2-year oral gavage test in B6C3F1 mice and F344 rats (Cronkite, 1989; NTP,
1986). However, there was no increase in tumour incidence in two out of three
inhalation tests in rats exposed to 100-300 ppm benzene for 99-123 weeks (Maltoni
et al, 1989; Snyder et al, 1978, 1984).
There was an increased incidence of epithelial skin tumours in male rats in two 2-
year oral bioassays. In both studies, however, the increase only occurred at the
highest dose level tested (200 and 500 mg/kg/day respectively), which may have
exceeded the maximum tolerated dose. Mammary gland carcinomas were increased
in female mice at 50 and 100 mg/kg/day in a 2-year and at 500 mg/kg/day in a 78-
week test.




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10.8      Summary and conclusions
          Taken together, the tests summarised above clearly demonstrate that benzene is not
          highly acutely toxic to experimental animals, whereas it is a potent, multi-organ
          toxicant by repeated administration. The target organs include the CNS, skin, eyes,
          immune system, blood and blood forming organs, gonads and developing foetus.
          Benzene is also toxic to genetic material and induces a variety of solid tumours,
          including mammary cancer in female mice.
          The only consistently reported acute systemic effects are CNS depression and
          cardio-respiratory arrest. In rats, the median lethal dose is 810-9900 mg/kg by
          mouth and 13,700 ppm by 4-h inhalation.
          Topically, benzene appears to be irritating to the skin and eyes.
          Of the available repeated dose oral studies, only the US National Toxicology
          Program's 2-year bioassays in mice and rats have been conducted and reported in
          full compliance with GLP and other internationally recognised quality standards
          (NTP, 1986). In these studies, benzene administered by oral gavage induced
          leukopoenia and lymphocytopoenia and an increase in the incidence of malignant
          tumours at the lowest dose level tested, namely 25 mg/kg/day in male and female
          mice and female rats and 50 mg/kg/day in male rats. In other oral studies of a lesser
          quality, benzene produced leukopoenia in mice and rats and signs of
          immunosuppression in mice at dose levels from 8-12 mg/kg/day.
          With regard to repeated exposure by inhalation, which is the predominant route in
          humans, the studies available for assessment were either poorly reported or
          inadequate for the determination of dose-response relationships for other reasons,
          such as an insufficient number of animals or range of exposure levels. Nonetheless,
          the weight of evidence indicates that the following approximate effect levels are
          likely to apply:
              In mice but not in rats, subtle signs of neurobehavioural stimulation may be
          ·
              detectable at vapour concentrations around 1 ppm, whereas gross CNS
              impairment only occurs at and above 1000 ppm. ;
              There are functional disturbances of the immune system at and above 10 ppm
          ·
              in mice, but no such effects in rats below 400 ppm. The NOAELs were
              determined to be 0.44 and 200 ppm for mice and rats respectively;
              Abnormal blood counts and morphological abnormalities in blood forming
          ·
              organs are found at and above 10 ppm in mice (including mouse foetuses
              exposed in utero) and at and above 100 ppm in rats. As effects were observed
              at all concentrations tested, a NOAEL could not be determined;
              There are degenerative changes in the gonads at 300 ppm in mice, but not in
          ·
              rats. The NOAEL was determined to be 30 ppm for mice ;
              Benzene is foetotoxic, but not teratogenic in rats and mice exposed during
          ·
              pregnancy at levels in the 100-500 ppm range, with an inhalation NOAEL for
              foetotoxicity of 40 ppm in rats; and
              The incidence of solid tumours is increased in mice exposed to 100-300 ppm
          ·
              benzene for 16 weeks, but not consistently in mice exposed to 1200 ppm for 10
              weeks or in rats exposed to 100-300 ppm for 99-123 weeks.
          The relevance of these findings for human risk characterisation will be examined in
          Section 13, in the context of the interspecies variations in benzene metabolism

Benzene                                        69

addressed in Section 9, the human health effects reviewed in Section 11, and the
molecular mechanisms of action discussed in Section 12.




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          11. Human Health Effects

          The literature on human health effects of benzene is extensive and contains data on
          hundreds of thousands of people. This section summarises and reviews studies that
          are relevant to the characterisation of the toxic effects of benzene and the
          corresponding effect levels. Because of the nature of the available studies, the
          review is predominantly based on findings in people who were exposed to benzene
          at work or held jobs with the potential for exposure to the chemical.
          The findings reported below must be interpreted with caution, as they rely on
          inherently uncertain information about the exposure of individuals or populations
          to benzene, which was either inferred or, at best, estimated from limited monitoring
          data. Furthermore, in the vast majority of cases there was co-exposure to other
          chemicals. These may be hazardous in their own right or inhibit the metabolism of
          benzene to toxic metabolites, thus resulting in either an over- or underestimation of
          the toxic potential of benzene. For example, the aromatic organic solvent toluene
          may interfere with the metabolism of benzene as well as cause brain atrophy and
          developmental toxicity (IPCS, 1985; Wilkins-Haug, 1997); some of the polycyclic
          aromatic hydrocarbons (PAHs) that occur in petroleum, coal gas, coal tar and
          vehicle exhaust are genotoxic and cause anaemia, immunosuppression and non-
          melanoma skin cancer (IPCS, 1998); and 1,3-butadiene found in vehicle exhaust is
          genotoxic and may increase the risk of blood and lymphatic cancers (IARC, 1999).
          Moreover, many studies are not controlled for confounding by smoking, although
          tobacco smoke contains benzene (see Section 16.1) and several studies have found
          an association between active smoking and leukaemia and reproductive effects
          such as semen quality and pregnancy outcome (Brownson et al, 1993; Vine, 1996;
          Werler, 1997).
          Unless otherwise mentioned, all results were statistically significant in comparison
          with unexposed controls (p <0.05). In occupational studies, chronic inhalation
          exposures refer to 8-h TWA (TWA8) concentrations. Technical terms used to
          describe epidemiological study designs and statistics have the meaning given in
          Last (1995).

11.1      Acute toxicity
          Cases of acute intoxication have occurred because of workplace accidents and in
          persons sniffing benzene-containing products for recreational purposes (Avis &
          Huton, 1993; Barbera et al, 1998; Tauber, 1970; Winek & Collum, 1971). The
          approximate lethal dose is 20,000 ppm by inhalation for 5-10 min, or 125 mg/kg by
          ingestion, whereas exposure to 25 ppm for 8 h is reported to be without clinical
          effects (Gerarde, 1960; Thienes & Haley, 1972, as cited in IPCS, 1993). No
          adverse effects were reported in three kinetic studies in healthy volunteers exposed
          to benzene levels of 26-42 ppm for 6 h, 52-62 ppm for 4 h or 47-110 ppm for 2-3 h
          (Berlin et al, 1980; Nomiyama & Nomiyama, 1974a; Srbova et al, 1950). Clinical
          signs at higher exposure levels include generalised symptoms such as dizziness,
          headache and vertigo at levels of 250-3000 ppm, leading to drowsiness, tremor,
          delirium and loss of consciousness at 700-3000 ppm (ATSDR, 1997; USEPA,
          1998c). Unless fatal, the CNS symptoms are reversible following cessation of
          exposure. Autopsy findings are typical of cardio-respiratory arrest.


Benzene                                        71

11.2   Irritation
       Aspiration of liquid benzene has been observed to cause immediate pulmonary
       oedema and bleeding at the site of contact (Gerarde, 1960). Benzene vapours have
       been reported to cause eye and mucous membrane irritation in workers exposed at
       33-59 ppm and irritation of the skin, nose, mouth and throat at levels 60 ppm
       (Midzenski et al, 1992; Yin et al, 1987a). Acute tracheitis, laryngitis, bronchitis and
       massive haemorrhage of the lungs were observed in a youth who died from an
       overdose of intentionally inhaled benzene (Winek & Collum, 1971). Second degree
       burns to the face, trunk and limbs were reported in chemical cargo ship crew
       accidentally exposed to fumes at a concentration resulting in death within minutes
       (Avis & Hutton, 1993).

11.3   Sensitisation
       There are no reports of skin or respiratory sensitisation to benzene in humans.

11.4   Repeated dose toxicity (other than carcinogenicity)

11.4.1 Neurological effects
       Yin et al. (1987a) found a dose-dependent increase in the prevalence of dizziness
       and headache in a survey of female Chinese workers in the footwear and printing
       industries. This study included 87 unexposed controls and two groups exposed to
       benzene at levels ranging from 1-40 ppm (40 cases) or 41-210 ppm (47 cases). In
       the two groups combined, benzene levels averaged 59 ppm. Both groups were co-
       exposed to low levels of toluene (16 ppm).
       Peripheral neuropathy was reported in a small number of Turkish workers with
       benzene-induced aplastic anaemia or preleukaemia (Baslo & Aksoy, 1982). At a
       benzene-manufacturing petrochemical plant in Estonia, frequent headaches at the
       end of the shift, tiredness, sleep disturbances and memory loss occurred in 61% of
       workers exposed to levels in the 2-16 ppm range for several years (Kahn &
       Muzyka, 1973). In a survey of deck crew on nine Norwegian petroleum product
       tankers, headache, dizziness or nausea were reported by 5/11 workers exposed to
       >0.3 ppm benzene whereas there were no CNS complaints in 10 workers exposed
       to 0.3 ppm (Moen et al, 1995). Psychological examinations in 28 men exposed to
       a mixture of benzene (0.56-1.8 ppm), toluene (2.1-9.8 ppm) and xylenes (0.43-12
       ppm) indicated diminished function of some cortical centres and impaired motor
       reaction time (Sikora & Langauer-Lewowicka, 1998). Varelas et al. (1999) used
       computed tomography imaging to visualise abnormal calcifications and cortical
       atrophy in the brains of 122 petrol station workers, taxi and bus drivers in central
       Athens. The subjects had been in their present employment for a minimum of 3 and
       an average of 16-17 years. Whereas blood lead levels were unremarkable in all
       three groups, there was mild to moderate cortical atrophy in 19/37 petrol station
       workers, 14/44 taxi drivers and 14/41 bus drivers. The prevalence in petrol station
       workers was higher than in taxi and bus drivers and unrelated to smoking or
       alcohol habits. None of these studies included an unexposed control group.

11.4.2 Effects on the immune system
       There was a decrease in circulating IgA and IgG immunoglobulins, accompanied
       by an increase in IgM and an elevated occurrence of leukocyte auto-antibodies, in

                                                                Priority Existing Chemical Number 21
                                             72

          painters co-exposed to benzene, toluene and xylenes at air levels ranging from 3-
          57, 21-71 and 27-680 ppm respectively (Lange et al, 1973a, 1973b). In workers co-
          exposed to benzene, toluene and xylenes at air levels that averaged from 1-35, 2-32
          and 4-28 ppm respectively over an 11-year period, total LC and T-LC counts were
          slightly lower in workers exposed for 55-122 months than in an unexposed control
          group, whereas there were no differences in LC function as determined by LC
          transformation and tuberculin tests (Moszczynsky & Lisiewicz, 1984).

11.4.3 Cardiovascular effects
          Kotseva & Popov (1998) conducted a routine cardiological examination of a
          sample of male and female petrochemical workers aged 20-60 years. It included
          118 workers concomitantly exposed to 20 ppm benzene and low levels of toluene
          and petrol as well as 154 workers concomitantly exposed to <3 ppm benzene, 32
          ppm xylenes and low levels of toluene and petrol. Compared to unexposed controls
          matched for age, sex, salt intake, smoking and body mass index, the prevalence of
          arterial hypertension and minor electrocardiographic abnormalities was
          approximately twice as high in the exposed groups.

11.4.4 Haematological effects
          Benzene has been known to be toxic to the blood for more than a hundred years
          and in the past was sometimes given orally to leukaemia patients to reduce WBC
          count (ATSDR, 1997; Landrigan, 1996).

          Occupational exposure

          Table 11.1 summarises a number of surveys of non-cancerous blood disorders in
          workers exposed to airborne benzene. Overall, these studies point to a strong
          association between recent or current exposure to airborne benzene and the
          occurrence of decreased ALC, WBC, RBC and Plt counts, Hb and haematocrit
          (Hct), and an increase in MCV. Such cases are sometimes described as `benzene
          poisoning' (BP). Depending on the pattern and magnitude of these changes and the
          histological findings in a bone marrow biopsy, they may be clinically diagnosed as
          lymphocytopoenia, leukopoenia, anaemia, thrombocytopoenia, pancytopoenia,
          agranulocytosis, myelofibrosis, or aplastic anaemia. They may be accompanied by
          clinical signs such as paleness, increased susceptibility to infections, and a
          tendency to bruising and bleeding. BP is generally reversible upon cessation of
          exposure, except aplastic anaemia which may be fatal or progress to acute myeloid
          leukaemia (AML) (Aksoy, 1989).
          Among the studies summarised in Table 11.1, three surveys comprising a total of
          795 workers found no adverse haematological effects from long-term benzene
          exposure at levels averaging 0.55, 0.81 and 0.53 ppm respectively (Collins et al,
          1997; Khuder et al, 1999; Tsai et al, 1983). These studies have limitations with
          respect to blood analysis methodology, exposure assessment and/or control for
          confounders such as smoking and co-exposure to other chemicals. Nevertheless,
          taken together they indicate that the NOAEL for bone marrow toxicity is likely to
          be >0.5 ppm.




Benzene                                       73

                                        Table 11.1: Summary of haematological effects in workers exposed to airborne benzene
                                       Industry                                                        Condition(s) observed                                                Comments                          Reference
                                                        Country Benzene exposure (TWA8)*

                                       Chemical         USA       Range = 0.01-1.40 ppm for an                                                                                                                Collins et al.
                                                                                                       In 200 exposed compared to 268 non-exposed workers there was no
                                                                  average of 7.3 years                                                                                                                        (1991)
                                                                                                       consistent benzene-related effect on haematology surveillance
                                                                                                       indicators

                                                        USA       Mean (range) = 0.55 (0.01-88) ppm,                                                                                                          Collins et al.
                                                                                                       In 387 exposed compared to 553 non-exposed workers there was no
                                                                                                                                                                                                              (1997)
                                                                  with <5% of workers exposed to       difference in the prevalence of decreased ALC, RBC, WBC or Plt
                                                                  levels >2 ppm                        counts, decreased Hb levels, or increased MCV values

                                                        USA                                                                                                                                                   Fishbeck et al.
                                                                  Mean >24 ppm for an average          10/10 workers had increased MCV values and 9/10 also had
                                                                                                                                                                                                              (1978)
                                                                  of 9.6 years                         decreased Hb levels
                                                        USA                                                                                                                 2/282 exposed workers died from Townsend et al.
                                                                  From <2 to about 30 ppm for 1-20     Marginally lower RBC count and total bilirubin in 282 exposed
                                                                                                                                                                                                            (1978)
                                                                                                                                                                            leukaemia during the study
                                                                  years                                workers compared to an equal number of matched controls
                                                                                                                                                                            period (1967-74)

                                       Coke oven        USA                                                                                                                                                   Hancock et al.
                                                                  0.1-31.4 ppm                         No differences in WBC, RBC or Hb values between groups of 17-37
                                       by-products                                                                                                                                                            (1984)
                                                                                                       workers with no, low (<2 ppm-years), intermediate (2-20 ppm-years)
                                                                                                       or high (>20 ppm-years) exposure

                                       Footwear         Turkey                                                                                                                                                Aksoy et al.
                                                                                                                                                                            Exposed to adhesives. No
                                                                  15-210 ppm for 3 months              Increased incidence of reduced WBC and/or Plt or CBC counts in
                                       manufacturing                                                                                                                                                          (1971)
                                                                                                                                                                            correlation with duration of
                                                                                                       217 workers compared to 100 controls matched for sex, age and
                                                                  to 17 years




  74
                                                                                                                                                                            exposure
                                                                                                       general living conditions

                                                        Croatia                                                                                                                                               Bogadi-Sare et
                                                                                                                                                                            Benzene contaminated glues,
                                                                  Median (range) = 5.9 (1.9-14.8) ppm Decreased mean Hb concentration and percentage of B-LC and
                                                                                                                                                                                                              al. (1997, 2000)
                                                                                                                                                                            cleaners and paints; co-exposed
                                                                                                      increased MCV and band neutrophils in 49 exposed females
                                                                  (area monitoring)
                                                                                                                                                                            to 11-50 ppm toluene
                                                                                                      compared to 27 unexposed controls

                                       Miscellaneous    Italy                                                                                                                                               Vai et al. (1989)
                                                                                                                                                                            There was a highly significant
                                                                  >20 ppm                              Of 301 workers referred to an occupational health clinic with
                                       uses of benzene-                                                                                                                     correlation between severity of
                                                                                                       suspected benzene intoxication, 153 had transient and 39
                                       based solvents                                                                                                                       bone marrow disease and current
                                                                                                       progressive bone marrow abnormalities; 11 died from aplastic
                                                                                                                                                                            or recent exposure
                                                                                                       anaemia and 21 developed cancers of the blood and lymphatic
                                                                                                       system

                                                        China                                                                                                                                                 Rothman et al.
                                                                                                                                                                          No correlation between any
                                                                  Median (range) current personal      In 44 exposed workers compared to an equal number of controls
                                                                                                                                                                                                              (1996a, 1996b)
                                                                  exposure = 31 (1.6-328.5) ppm,       matched for sex, age, cigarette and alcohol consumption, WBC, ALC, haematological parameter and
                                                                  with an average duration of          Plt, RBC and Htc levels were reduced and MCV values increased. In cumulative exposure
                                                                  exposure of 6.3 years                11 workers exposed to a median (range) level
                                                                                                       of 7.6 (1-20) ppm, only ALC was decreased

                                                        China                                                                                                                                                 Xia et al. (1995)
                                                                  Mean (range) = 5.8 (0.7-139) ppm     26% of 326 exposed workers had leukopoenia (WBC count <4.5 x
                                                                  (assessment method not specified)    109/L) compared to 8.9% of 236 non-exposed workers




Priority Existing Chemical Number 21
                                                        China                                                                                                                                                 Yin et al. (1987a)
                                                                                                                                                                            Co-exposed to 6-7 ppm toluene
                                                                  Mean (maximum) = 59.2 (210) in       Decrease in ALC in 83 exposed women compared to 85
                                                                  women and 47.9 (210) ppm in          unexposed controls, but no differences between 61
                                                                  men, for an average of 5 years       exposed men and 44 unexposed controls

           Table 11.1: Continued
                                                                          Condition(s) observed                                                 Comments                           Reference
          Industry       Country Benzene exposure (TWA8)

                         Canada                                                                                                                                                    Khuder et al. (1999)
          Petroleum                Mean (range) = 0.81 (0.14-2.08) ppm In 105 exposed workers, levels of WBC, RBC, Hb, MCV and Plt were




Benzene
                                   for an average of 10 years
          refining                                                     generally in the low normal range. MCV and Plt values were
                                                                       negatively correlated with duration of employment, but not with
                                                                       individual benzene exposure

                         USA       Median = 0.53 ppm                                                                                                                               Tsai et al. (1983)
                                                                          All haematological parameters generally within normal limits in 303
                                                                          workers followed from 1959-1980

                         UK                                                                                                                                                        Yardley-Jones et al.
                                                                          In 66 exposed compared to 33 non-exposed workers,                     All absolute MCV values were
                                   10 ppm
                                                                                                                                                                                   (1988)
                                                                                                                                                within the normal clinical range
                                                                          there was no difference in various unspecified
                                                                          haematology and serum biochemistry values, except
                                                                          for a small increase in MCV values in exposed workers

                         USA       11-1060 ppm for 3-5 years                                                                                                                       Greenburg et al.
          Printing                                                        130/332 exposed workers showed signs of intoxication, including       No cases of relapse after
                                                                                                                                                                                   (1939)
                                                                          anaemia, increased MCV, reduced Plt counts and/or reduced             benzene use was discontinued
                                                                          WBC counts

                        USA        Median exposure estimated at                                                                                                                    Cody et al. (1993)
          Rubber                                                          In 161 workers hired between 1946-49, there was a 10% decline         Pliofilm cohort
                                   30-54 ppm
          manufacturing                                                   in WBC counts over the first 4 months of employment, but no           (Section 11.6.1)
                                                                          consistent changes in RBC levels




75
                         USA       Mean estimated at 75 ppm during                                                                                                                 Kipen et al. (1988,
                                                                          In a longitudinal study of 459 workers, WBC, RBC and Hb levels        Pliofilm cohort
                                   1940-48 and at 15-20 ppm during                                                                                                                 1989)
                                                                          decreased with total exposure between 1940-48, but showed no          (Section 11.6.1)
                                   1949-78                                persistent trends over the ensuing 25 years

                                   Range estimated at <5-34 ppm
                         USA                                                                                                                                                       Ward et al. (1996)
                                                                          Haematological screening data for 657 workers exposed between         Pliofilm cohort
                                                                          1939 to 1975 showed a relationship                                    (Section 11.6.1)
                                                                          between benzene exposure and the risk of a low WBC or RBC
                                                                          count which was stronger for WBC, with no evidence
                                                                          for a threshold exposure level

                         USA       Mean and range estimated at 100                                                                                                                 Wilson (1942)
                                                                          Following complaints of malaise, nausea, vomiting, and bleeding,      Outbreak coincided with large
                                   and 50-500 ppm respectively            blood counts were done on 1104 workers. ALC was abnormally            war orders for synthetic rubber
                                                                          low in 83 of them and 25 had severely reduced WBC, RBC and Plt
                                                                          counts. Of these, 9 were hospitalised, where aplastic anaemia
                                                                          was diagnosed by bone marrow biopsy; 3 died.

                         USA       60-600 ppm                                                                                                                                      Midzenski et al.
          Ship repair                                                                                                                           No relationship between blood
                                                                          9/15 workers exposed over several days from the
                                                                                                                                                                                   (1992)
                                                                                                                                                changes and duration of
                                                                          degassing of shipboard tanks developed abnormal WBC, ALC,
                                                                                                                                                exposure
                                                                          Hb, Plt and/or MCV values within 4 months. At 12 months, 7/15
                                                                          still had one or more abnormal values.
                        Turkey     0-110 ppm (area monitoring)                                                                                                                     Aksoy et al. (1987)
                                                                                                                                                Used thinners and solvents
          Tyre cord                                                       Decreased WBC count in 9, decreased Plt count in 4 and
                                                                                                                                                containing up to 6-8% benzene
          manufacturing                                                   decreased WBC, RBC and Plt count in 1 of 231 exposed workers

           * TWA8 = 8-h time-weighted average.
           
             CBC = complete blood cell count; for other abbreviations, see text.

In 44 Chinese workers exposed to a median benzene concentration of 31 ppm, with
a range from 1.6-328.5 ppm, Rothman et al. (1996a, 1996b) found a decrease in
WBC, RBC and Htc, an increase in MCV and an inverse correlation between ALC
and benzene exposure. In a subgroup of these workers with a median exposure
level of 7.6 ppm (range: 1-20 ppm), the lowest exposure group examined, the only
haematological finding was a 16% decrease in ALC (1.6 x 109/L compared to 1.9 x
109/L in controls; p = 0.03). This study is small, but had a well-matched control
group, minimal exposure to other chemicals (toluene and xylenes) and a dose-
response relationship was established between ALC and benzene exposure as
measured by repeated personal monitoring as well as with benzene metabolites in
the urine.
Three other studies reported haematological effects in workers whose exposure was
stated to range from 1.9-14.8 (median: 5.9), <5-34 and 0.7-139 (mean: 5.8) ppm
respectively (Bogardi-are et al, 1997; Ward et al, 1996; Xia et al, 1995). However,
these studies assessed exposure by means of area monitoring, a job-exposure
matrix or unspecified methods and are therefore less suitable for dose-response
characterisation.
Repeated exposure at higher levels was usually associated with clear signs of BP in
some workers, with little or no relationship with cumulative exposure (Aksoy et al,
1971; Midzenski et al, 1992; Rothman et al, 1996a, 1996b; Vai et al, 1989).
Dosemeci et al. (1997) evaluated the statistical relationship between a clinical
diagnosis of BP and benzene exposure in a subgroup of 412 cases drawn from a
large Chinese cohort study (Hayes et al, 1997), which is described in detail in
Section 11.6.1. The cumulative incidence of BP (defined as (1) a WBC count <4 x
109/L or a WBC count <4.5 x 109/L and a Plt count <80 x 109/L over several
months, (2) occupational benzene exposure for 6 months and (3) exclusion of
other causes of abnormal blood counts) rose sharply with increasing estimated
intensity of benzene exposure over a period of 18 months prior to diagnosis, as
shown by the following relative risks (RRs):
    Exposure                 <5 ppm              5-19 ppm          20-39 ppm           40 ppm
    RR (95% CI)6      1.0 (reference level)     2.2 (1.7-2.9)     4.7 (3.4-6.5)      7.2 (5.3-9.8)

The clear trend with the level of exposure is noteworthy, even if the absolute
exposure levels may have been underestimated, as discussed in Section 11.6.1
below.
The risk of BP developing into cancer was assessed in a subgroup of 11,177
benzene-exposed workers from the same Chinese cohort, 103 of whom had BP as
defined above (Rothman et al, 1997). At follow-up 4-14 years after diagnosis, three
of the cases had developed acute non-lymphocytic leukaemia (ANLL), non-
Hodgkin's lymphoma (NHL) and myelodysplastic syndrome (MDS) respectively,
compared to 6 cases of cancer of the blood and lymphatic system (including 2 with
ANLL) and 1 case of MDS among the 11,074 workers without a diagnosis of BP
(Table 11.2)7. The corresponding RRs indicate that a diagnosis of BP is associated


6
  Throughout this section, ranges in brackets immediately following a relative risk (RR), odds ratio
(OR), standardised mortality rate (SMR) or standardised incidence rate (SIR) represent the 95%
confidence interval (CI) of the statistic.
7
  ANLL comprises all acute leukaemias other than acute lymphocytic leukaemia and can usually be
equated to AML. MDS is a term that encompasses a variety of preleukaemic disorders.
                                                                 Priority Existing Chemical Number 21
                                           76

          with a 42-fold increase in the risk of pre-cancer or cancer of the blood and
          lymphatic system and with a 71-fold increase in the risk for ANLL/MDS. The RRs
          changed little upon adjustment for cumulative exposure, indicating that the elevated
          cancer risk was not due to a higher cumulative exposure in the 103 BP cases.

          Table 11.2: Benzene poisoning and subsequent risk of blood and lymphatic
          system cancer and related disorders (Rothman et al, 1997)

                                                                           Without
                                                                           benzene         With benzene
          Parameter*                                                      poisoning         poisoning
          Person-years of follow-up                                         122,620              848
          RR (95% CI) of all pre-cancer or cancer of the blood and
          lymphatic system                                                    1.0         42.3 (10.7-167.0)
          RR (95% CI) of ANLL/MDS                                             1.0         70.6 (11.4-439.3)
          RR (95% CI) of all pre-cancer or cancer of the blood and
          lymphatic system, adjusted for cumulative benzene                   1.0         47.4 (11.7-191.9)
          exposure
          RR (95% CI) of ANLL/MDS, adjusted for cumulative
          benzene exposure                                                    1.0         61.3 (9.8-384.3)

          * ANLL = acute non-lymphocytic leukaemia; CI = confidence interval; MDS = myelodysplastic syndrome;
          RR = relative risk.

          Similarly, Vai et al. (1989) reported 28 cases of fatal blood cancer among 304
          workers in Northern Italy who were hospitalised 15-35 years earlier with suspected
          BP, representing a 13.3-fold increase over the incidence in the general population
          in the region.

          Public exposure

          In the 1980s, the US Federal Department of Health and Human Services created a
          National Exposure Registry to assess the health consequences to the general
          population from long-term, low-level exposure to specific substances in the
          environment. A Benzene Subregistry was established in 1991 based on a
          population health survey in a community in Texas, USA, where tap water from the
          public water system was known to have contained 66 µg/L benzene since 1
          January 1979 (Burg & Gist, 1998). The survey included 1,143 persons who had
          used contaminated water as the sole source of drinking, bathing and cooking for at
          least 30 consecutive days. These persons were administered a questionnaire and
          follow-up telephone interviews were conducted one and two years later. The
          questions asked were similar to those used in the National Health Interview Survey
          (NHIS) conducted every year in USA, except that the benzene questionnaire
          contained a qualifier relating to professional rather than self diagnosis of ailments,
          so as to minimise reporting bias. Findings were compared with concurrent NHIS
          data subsets matched for demographic variables and current and ever smoking
          rates. The initial response rate was 97%. There was a loss of 9% for each follow-up
          from the previous data collection.
          The outcome of anaemia and related blood disorders within the last 12 months was
          reported in excess at all three data collections, with 40 observed vs. 14.1 expected
          cases at baseline, 32 observed vs. 11.6 expected cases at one year (p <0.01), and 28
          observed vs. 11.9 expected cases at two years. There was no difference in the
          reporting of cancer.



Benzene                                              77

       Conclusions

       Several occupational surveys show that chronic exposure to benzene may lead to
       bone marrow depression, with manifestations that range from small reductions in
       blood count parameters to aplastic anaemia. The available data indicate that both
       the incidence and severity of this effect is dose-related. In a small, but reliable
       study, the only haematological effect in workers with a median (range) exposure of
       7.6 (1-20) ppm (TWA8) was a modest reduction in ALC. As this was the lowest
       exposure group examined, 7.6 ppm (TWA8) is currently considered the best
       estimate for a LOAEL which may be close to the point of departure for the onset of
       haematological effects (USEPA, 1998c). An appropriate NOAEL has not been
       determined, but studies with various limitations indicate that it is likely to be >0.5
       ppm (TWA8).
       The only available epidemiological study in the general population found an excess
       occurrence of anaemia and related disorders in a community whose tap water
       contained 66 µg/L benzene.
       There is some evidence that bone marrow depression is associated with a
       substantially increased risk for ANLL/MDS.

11.4.5 Reproductive effects

       Effects on fertility

       Vara & Kinnunen (1946) reported a variety of gynaecological disorders in 12
       female rubber workers who were exposed to unspecified levels of benzene on a
       daily basis. All 12 women had menstruation disorders, with sparse bleeding being
       the most common complaint. Although most of the women practised regular
       unprotected intercourse, only two of them had conceived since they started working
       and both pregnancies ended in spontaneous abortions (SAb) by the first trimester.
       Five had ovarian hypoplasia. Other common findings included excessive bruising,
       tiredness, dizziness, headaches and abnormal haematological findings, particularly
       low WBC and Plt counts.
       Menstruation abnormalities have also been reported in surveys of female workers
       exposed to mixed aromatic hydrocarbons including benzene or to benzene,
       petroleum and chlorinated hydrocarbons in Poland and Russia in the 1960s
       (Michon, 1965; Mukhametova & Vozovaya, 1972; both as cited in ATSDR, 1997)
       and in female workers at a large petrochemical company in China (Thurston et al,
       2000). Huang (1991) reported menstruation disorders in 49% of 223 Chinese
       leather footwear workers co-exposed to an average of 29 (range: 1-132) ppm
       benzene and 19 (range: 1-136) ppm toluene compared to a prevalence of 16% in
       unexposed controls (p <0.01). There is no information on the smoking habits of the
       study population.
       Benzene exposure as a risk factor for fecundability (time to pregnancy) was
       assessed in a Norwegian case-control study in 558 female dental surgeons and 450
       high school teachers with at least one child (Dahl et al, 1999). Forty percent of the
       dentists reported daily exposure to a now discontinued disinfectant containing
       0.25% v/v benzene. There was no difference in fecundability between dental



                                                               Priority Existing Chemical Number 21
                                            78

          surgeons exposed to benzene and the controls. Potential confounders were
          considered, but the level of benzene exposure resulting from the disinfectant was
          not assessed.
          In males, De Celis et al. (2000) studied the sexual functioning and semen profile of
          48 Mexican rubbers workers exposed to a mixture of benzene (10-15 ppm), ethyl
          benzene (~50 ppm), toluene (~50 ppm) and xylenes (~12 ppm) for 2 years. Mean
          sperm count and the mean percentage of motile and normal sperm forms were
          reduced by 78, 62 and 24% respectively, compared to a group of 42 age-matched
          controls. There was no correlation between smoking or alcohol intake and
          alterations in the semen profile. Longer abstinence intervals may have contributed
          to the reduced sperm concentration and motility in exposed workers as they also
          had an increased prevalence of reduced libido.

          Effects on pregnancy outcome

          Huang (1991) investigated pregnancy outcome in 106 Chinese leather footwear
          workers co-exposed to an average of 29 ppm (range: 1-132) ppm benzene and 19
          (range: 1-136) ppm toluene and 209 unexposed controls. Exposure to benzene and
          toluene was associated with an elevated incidence of SAb (5.8 vs. 2.4%; RR = 2.4;
          p <0.01), whereas there was no difference in the incidence of preterm delivery or
          stillbirth. There is no information on the smoking habits of the study population.
          Lindbohm et al. (1991) used Finnish census data, hospital records and industry-
          wide air monitoring results collected in 1975-82 to study the outcome of 11,570
          pregnancies with potential paternal exposure to hazardous chemicals compared
          with a control group of 87,616 unexposed pregnancies. The RR for SAb was
          elevated for paternal exposure to solvents used in petroleum refineries, but did not
          differ significantly from unity when analysed separately for exposure to benzene.
          Although not quantified, benzene exposure levels were estimated to be low.
          In a case-control study of female workers in the Finnish pharmaceutical industry
          which included 44 cases of SAb and 130 matched controls, Taskinen et al. (1986)
          found a non-significant association between abortion risk and benzene exposure
          (OR = 2.4 (0.5-12.0)).
          The effects of parental occupational exposures on foetal development were
          investigated in an exploratory case-control study based on probability samples of
          live births and foetal deaths obtained by the US National Natality and Fetal
          Mortality survey conducted in 1980 among married women (Savitz et al, 1989).
          The samples included case groups of stillbirths (2096 mothers, 3170 fathers),
          preterm deliveries at <37 weeks of pregnancy (363 mothers, 552 fathers) and
          small-for-gestational age (SGA) infants (218 mothers, 371 fathers). Control
          pregnancies were drawn from the same survey. Occupational exposures within the
          last 12 months were defined by industry of employment and relative levels of
          exposure to individual agents estimated on the basis of a job-exposure linkage
          system. In computing the OR, adjustments were made for known confounding
          factors for each pregnancy outcome, such as child's race, receipt of prenatal care,
          mother's age, number of previous miscarriages, previous induced abortions and
          maternal smoking and alcohol consumption.
          Overall, this study found a significantly elevated SGA risk in the offspring of
          fathers exposed to benzene at work (OR = 1.5 (1.1-2.3)), with a strong dose-
          response gradient. Benzene-exposed fathers of SGA infants included a large
          percentage of engine mechanics and repairers, welders and flame cutters. Maternal

Benzene                                       79

benzene exposure showed a marginally significant association with stillbirths (OR
= 1.3 (1.0-1.8)), which was supported by the demonstration of a dose-response
gradient. In these mothers, benzene exposure was attributed mainly to work in the
textile industry, barbering and cosmetology, with smaller contributions from the
chemical, pharmaceutical and paint industries.
Stücker et al. (1994) evaluated the risk of SAb before 28 weeks among the spouses
of 1077 male workers at two organic chemical factories in France, on the basis of
exposures estimated by plant occupational physicians and questionnaires
administered to the men and their wives. Medical records of the women were not
examined. There was a total of 1739 pregnancies, of which 171 (9.8%) ended in
SAb. The abortion rate was 8.8% in the wives of unexposed workers. Workers
were divided into low (<5 ppm) and high (5 ppm) exposure categories depending
on their estimated past exposure to benzene. After adjustment for maternal tobacco
consumption, age and pregnancy order, the risk of SAb did not differ from unity in
either of the two exposure groups. Similar results were obtained in analyses of first
pregnancies only, and when pregnancy outcome was examined against a more
detailed exposure graduation.
A Finnish case-control study of 206 cases of SAb in laboratory workers and 329
individually matched controls identified 11 cases of benzene exposure in the SAb
group compared to 25 among the controls and concluded that benzene exposure
was not a significant risk factor (Taskinen et al, 1994).
In a Chinese study, the overall risk of SAb in 3070 non-smoking, primiparous
women employed at a large petrochemical complex and married to male workers at
the same facility was 8.8% in chemical compared to 2.2% in non-chemical workers
(Xu et al, 1998a). Benzene, toluene, xylenes and styrene exposure levels in 38
breathing zone samples collected throughout the complex averaged 0.86, 0.40, 0.50
and 0.03 ppm respectively. In analyses for exposure to specific chemicals during
the first trimester of pregnancy, the estimated ORs of SAb were significantly
elevated for benzene (2.5 (1.7-3.7)) and petrol (1.8 (1.1-2.9)).
Chen et al. (2000) conducted a prospective study of pregnant workers at a Chinese
petrochemical plant producing benzene, toluene, xylenes, styrene and phenol.
Compared with 459 mothers not exposed to organic solvents, there was a small
reduction in birth weight (­58 g; 95% CI = ­115 to ­2 g) among 366 mothers
exposed to 0.02-0.2 ppm benzene with or without other exposures.

Conclusions

There are several reports of menstruation disturbances in female workers and one
of reduced semen quality in male workers exposed to benzene.
The available studies of pregnancy outcome have produced mixed results with
regard to the risk for SAb. One study found an elevated SGA risk for fathers with
occupational exposure to benzene. In another study, there was a marginally
significant reduction in birth weight in infants whose mothers had been exposed to
low levels of benzene at work.
However, all of the available studies have one or more limitations, such as multiple
exposures, inadequate adjustment for other confounders and/or inadequately
quantified exposure to benzene as well as other chemicals. Therefore, there is at
present no convincing evidence from human studies that benzene may have adverse
effects on reproduction.

                                                       Priority Existing Chemical Number 21
                                     80

11.4.6 Other health effects
          Chronic tiredness and headache and large, spreading bruises on the arms and legs
          have been described in a number of workers exposed to benzene air levels in the
          order of 100-200 ppm (Helmer, 1944).
          Yin et al. (1987a) conducted a survey of the prevalence of symptoms of
          intoxication in Chinese factory workers exposed to high levels of benzene or
          benzene and toluene for up to 40 years. There was a slight decrease in ALC in both
          groups. Sore throat and episodes of nose bleeding were common in all exposed
          workers and their frequency was related to benzene exposure levels.
          In an uncontrolled case report, Davidoff et al. (1998) described a group of workers
          who began complaining about petrol odour and symptoms of nausea, headache,
          throat and eye irritation, and cough while tunnelling underneath a former service
          station site. An air sample from the tunnel contained 60 ppm benzene. Eight out of
          30 randomly selected workers subsequently investigated in detail reported the post-
          incident onset of chemical hypersensitivities and other characteristics which,
          according to the authors, fitted conservative criteria for the diagnosis of multiple
          chemical sensitivities syndrome.

11.5      Genotoxic effects
          Several occupational studies conducted over the past 30 years point to a link
          between a number of unstable or stable, numerical or structural chromosome
          aberrations and benzene exposure (ATSDR, 1997; IPCS, 1993). In most cases,
          these studies were conducted in workers exposed to benzene levels >10 ppm.
          However, Tompa et al. (1994) analysed whole blood metaphase spreads from
          workers employed in an environment where improved working conditions over a 3-
          year period reduced average peak exposures from 21 ppm in 1990 to 8.4 ppm in
          1991 and 5.7 ppm in 1992. As shown in Figure 11.1, the reduction in benzene
          levels was paralleled by a decrease in the frequency of chromosome aberrations,
          but not in SCEs. These findings provide evidence of a direct relationship between
          benzene exposure and the extent of chromosome damage, but do not establish a
          threshold level for the effect.

          Figure 11.1: Changes in the frequency of SCEs and chromosome aberrations
          (excluding gaps) in workers exposed to progressively reduced benzene
          levels (Tompa et al, 1994)


                         10
                                                                          SCEs/cell
                          8
             Frequency




                                                                          C hro m o so m e
                          6
                                                                          ab erra tio ns (%)
                          4

                          2

                          0
                              25    20      15       10       5     0
                                   B enz en e concentration (ppm)




Benzene                                              81

Table 11.3 summarises a number of recent occupational studies which used
personal air monitoring to measure benzene exposure and modern cytogenetic
techniques such as polymerase chain reaction methods, 32P-postlabelling,
fluorescence in situ hybridization and alkaline single cell gel electrophoresis to
determine the genotoxic effects in various cell samples.

Table 11.3: Genotoxic effects in workers exposed to airborne benzene

Study population (number)
                                    Effects and effect levels (TWA8)*                        Reference
Exposed           Controls
Petrol station    Matched for       Excess of overall DNA damage and highly damaged          Andreoli et
attendants (12)   sex, age and      cells in freshly isolated non-cycling peripheral blood   al. (1997)
                  smoking           LC in subjects exposed to a mean air level of 0.11
                  habits (12)       ppm (range: 0.03-3.0 ppm) (Lagorio et al, 1997)
Petrol station    Matched for       No evidence of numerical aberrations involving           Carere et al.
attendants (12)   sex, age and      chromosomes 7, 11, 18 or X in peripheral blood LC        (1998)
                  smoking           of subjects exposed to an average air level of 0.1
                  habits (12)       ppm
                                    Increase in kinetochore-positive MN in T-LC, but no      Holz et al.
Styrene plant     Matched for
                                    changes in DNA adducts in MC or in DNA single            (1995)
workers (25)      sex and age
                                    strand breaks, SCE or total MN in LC at average
                  (25)
                                    exposure levels corresponding to 0.24 ppm benzene
                                    and 0.31 ppm styrene (as well as toluene, xylenes
                                    and ethylbenzene)
Coke gas plant    Matched for       No increases in the frequency of MN, MN harbouring       Surrallés et
workers (56)      age (28)          whole chromosomes or acentric chromosomal                al. (1997)
                                    fragments or chromosome 9 numerical abnormalities
                                    in LC and buccal cells at exposure levels from 0.5-
                                    1.2 ppm
Coke gas plant    Unmatched         Small but statistically significant increase in          Marcon et
workers (12)      inhabitants of    centromeric breakage of chromosomes 1 and 9 in           al. (1999)
and oven          neighbouring      interphase LC in benzene workers exposed to a
operators (5)     rural village     geometric average of 1.3 ppm benzene, but not in
                  (8)               coking oven workers exposed to a geometric
                                    average of 1.0 ppm
Workers using     Matched for       In heterozygous individuals, the frequency of NN but     Rothman et
benzene-based     sex, age,         not Nø GPA mutants was doubled in peripheral RBC         al. (1995,
solvents (24)     smoking,          and strongly correlated with lifetime cumulative         1996b)
                  drinking and      benzene exposure, at a mean exposure level of 72
                  obesity (23)      ppm (range: 2-301 ppm)
Workers using     Matched for       There was a dose-related increase in hyperdiploidy       Smith et al.
benzene-based     sex and age       at chromosomes 8 and 21 and in hypodiploidy at           (1998)
solvents (43)     (44)              chromosome 8 in LC of workers with a median
                                    exposure level of 31 ppm (range not specified).
                                    There was also a 15-fold increase in t(8;21) (27
                                    versus 2% LC) and a doubling of t(8;?) and t(21;?) in
                                    LC at exposures >31 ppm. All increases were
                                    related to current but not to cumulative exposure
                                    Increased frequency of hyperdiploidy at chromo-          Zhang et al.
                                    some 9, mainly trisomy, in LC at exposure levels         (1996)
                                    >31 ppm, which correlated with ALC decreases
                                    Increased frequency of monosomy at chromosomes           Zhang et al.
                                    5 and 7, in trisomy and tetrasomy at chromosomes         (1998)
                                    1, 5 and 7, and a dose-dependent, up to 3.5-fold
                                    increase in long arm deletions of chromosomes 5
                                    and 7 in whole blood metaphase spreads, at a
                                    median exposure level of 31 ppm (range: 2-329
                                    ppm)

* ALC = absolute lymphocyte count                  RBC = red blood cells
  GPA = glycophorin A                              SCE = sister chromatid exchange
  LC = lymphocytes                                 t(a;b) = translocations between chromosomes a and b
                                                   TWA8 = 8-h time-weighted average
  MC = monocytes
  MN = micronuclei                                 ? = unidentified chromosome.

The studies of Andreoli et al. (1997) and Carere et al. (1998) of petrol station
attendants exposed to benzene concentrations that averaged around 0.1 ppm are

                                                                     Priority Existing Chemical Number 21
                                              82

          difficult to interpret as there is no information on the nature and extent of co-
          exposure to other chemicals in petrol or vehicle exhaust fumes, which would
          include 1,3-butadiene and a number of genotoxic PAHs (IARC, 1999; IPCS, 1998).
          Furthermore, Carere et al. (1998) investigated only one of the six chromosomes in
          which aberrations have been found at high levels of benzene exposure.
          Holz et al. (1995) reported kinetochore-positive (that is, whole chromosome) MN
          in workers with an average exposure of 0.24 ppm benzene and 0.31 styrene.
          However, styrene alone is known to cause chromosome damage in human
          lymphocytes at low concentrations (IARC, 1994).
          In coal gas by-product workers, Surrallés et al. (1997) found no chromosome
          aberrations at benzene levels 1.2 ppm, whereas Marcon et al. (1999) found a small
          increase in centromeric breakages in chromosomes 1 and 9 at 1.3 ppm, but not in
          coke oven workers exposed to a slighter lower level averaging 1.0 ppm. However,
          coke oven and coal gas by-product workers are co-exposed to numerous PAHs,
          many of which have a variety of genotoxic effects at low concentrations (IPCS,
          1998).
          The main findings at exposure levels 31 ppm benzene were aneuploidy, long-arm
          deletions and translocations involving chromosomes 1, 5, 7, 8, 9 and 21 and gene
          duplication in nucleated RBC stem cells at the glycophorin A locus on
          chromosome 4 (Rothman et al, 1995, 1996b; Smith et al, 1998; Zhang et al, 1996,
          1998). The subjects of these studies were co-exposed to toluene and xylenes, which
          may inhibit the metabolism of benzene, but have not been shown to cause
          chromosome lesions that resemble the above (IPCS, 1997; McGregor, 1994).
          As such, whereas studies using modern cytogenetic techniques have shown a clear
          association between extensive chromosome damage and exposure to high benzene
          levels, they have not contributed to the definition of a threshold level for genotoxic
          effects in humans.

11.6      Carcinogenicity

11.6.1 Cohort studies

          Cohort studies with poorly characterised benzene exposure levels

          Table 11.4 summarises a number of occupational cohort studies with a combined
          study population approaching 450,000 workers holding jobs with the potential for
          exposure to benzene, mainly in the petroleum industry. They include the ongoing,
          prospective Health Watch (1998) cohort study, which covers about 95% of the
          Australian petroleum industry's 18,000 employees in refineries, natural gas plants,
          distribution terminals and production sites. They also include two meta-analyses
          based on a large number of petroleum industry cohorts (Raabe & Wong, 1995;
          Wong & Raabe, 1996, 2000). The most important limitation of these studies and
          meta-analyses is their lack of adequate data on benzene exposure levels.




Benzene                                        83

                                       Table 11.4: Summary of cohort studies in workers exposed to poorly characterised benzene levels

                                       Exposed population                              Controls                                           Ratio (95% CI)             Comments                                      Reference
                                                                                                              Health outcome*

                                       Chemical industry
                                                                                                              Any death rate
                                                                                       National population                                                                                                         Decouflé et al.
                                                                                                                                          No difference
                                       259 workers ever employed at a US benzene                                                                                     In 194 workers employed for 12 months,
                                                                                                                                                                                                                   (1983)
                                       alkylation plant from 1947-60 and followed up                                                                                 SMR for CBLS = 3.77 (1.09-10.24)
                                       for 17-30 years

                                                                                                              All-cause mortality
                                                                                       Architects from same                                                                                                        Olin & Ahlbom
                                                                                                                                          RR = 1.14 (0.91-1.37)
                                       822 chemists graduated from university in                                                                                     There were 10 cases of CBLS among the
                                                                                                              All cancer mortality
                                                                                       school                                                                                                                      (1980)
                                                                                                                                          RR = 2.54 (p <0.05)
                                       Stockholm, Sweden, between 1930-50 and                                                                                        chemists compared to 0 among the
                                                                                                              All CBLS
                                       followed up till the end of 1974                                                                                              architects; nine were organic chemists
                                                                                                                                          RR =  (p = 0.02)


                                       Coke oven and coal gas by-product workers
                                                                                       Regional population                                                                                                         Hurley et al.
                                                                                                                                                                     Benzene breathing zone levels were
                                                                                                              Leukaemia:
                                       2708 men employed by British Steel
                                                                                                                                                                                                                   (1991)
                                                                                                                                          SMR = 0.41 (0.05-1.47)     reported to average 1.3 ppm in by-product
                                       Corporation at 14 coke works in the UK in                              All workers
                                                                                                                                          SMR = 0.98 (0.02-5.57)     and 0.3 ppm in coke oven workers in the
                                       1967 and followed up for 20 years                                      By-product workers
                                                                                                                                          SMR = 0.35 (0.01-1.92)     1980s
                                                                                                              Coke oven workers
                                                                                       Regional population
                                       3812 men employed by National Smokeless                                Leukaemia:
                                                                                                                                          SMR = 0.42 (0.09-1.23)
                                       Fuels Ltd at 13 coke works in the UK in 1967                           All workers
                                                                                                                                          SMR = 0.76 (0.02-4.29)
                                       and followed up for 20 years                                           By-product workers




  84
                                                                                                                                          SMR = 0.34 (0.00-1.86)
                                                                                                              Coke oven workers
                                                                                                                                          SMR = 0.58 (0.01-3.28)
                                                                                                              Maintenance workers

                                                                                     National population                                                                                                           Swaen et al.
                                                                                                                                          SMR >1.00 (p< 0.05)        Among 222 benzene plant workers, death
                                                                                                              All-cause mortality, all
                                       5659 coke oven workers employed for 6
                                                                                                                                                                                                                   (1991)
                                                                                                                                                                     rates were similar to the expected figures
                                                                                                              cancer, liver cancer, and
                                       months from 1945-69 at a Dutch coke plant and
                                                                                                              respiratory disease
                                       followed up for 15-40 years


                                       Footwear manufacturing
                                                                                                                                                                                                              Paci et al.
                                                                                       National population                                                           Workers in some departments were
                                                                                                              Male workers (n = 1008):
                                       2013 men and women ever employed at an
                                                                                                                                          SMR <1.00 (p <0.05)        exposed to glues containing >70% benzene (1989)
                                                                                                              GI disease and accidents
                                       Italian shoe manufacturing plant from 1939-64
                                                                                                                                          SMR = 15.66 (5.47-32.64)
                                                                                                              Blood disease
                                       and followed up for 20-45 years
                                                                                                                                                                     All non-cancer blood disease cases were
                                                                                                                                          SMR = 1.40 (1.09-1.81)
                                                                                                              All cancer
                                                                                                                                                                     aplastic anaemia
                                                                                                                                          SMR = 2.40 (1.37-3.78)
                                                                                                              Stomach cancer
                                                                                                                                          SMR = 4.00 (1.46-8.70)
                                                                                                              Leukaemia                                              No relationship between leukaemia risk and
                                                                                                                                                                     duration of exposure
                                                                                                              Female workers (n = 1005):
                                                                                                                                                                     No information on job categories, which
                                                                                                                                         No difference
                                                                                                              Any cause of death
                                                                                                                                                                     likely may have explained negative findings
                                                                                                                                                                     in female workers




Priority Existing Chemical Number 21

           Table 11.4: Continued
          Exposed population                            Controls                                           Ratio (95% CI)           Comments                                Reference
                                                                              Health outcome*




Benzene
          Highway maintenance workers
                                                                              All-cause mortality and
                                                        Regional white                                                                                                      Bender et al.
          4849 men employed for at least 1 year                                                            SMR <1.00 (p <0.05)      In workers with 30-39 years of
                                                                              all cancer
                                                        population                                                                                                          (1989)
          between 1945-84 as highway maintenance                                                                                    employment, the SMR for leukaemia
          workers by the Department of Transportation                                                                               was 4.25 (1.71-8.76)
                                                                              All CBLS
          in Minnesota, USA                                                                                SMR = 0.95 (0.66-1.33)
                                                                              Leukaemia                    SMR = 1.07 (0.62-1.71)   No observed deaths from melanoma
                                                                                                                                    compared to 2.9 expected

          Petrol and petroleum distribution
                                                                              Male workers (n = 16,524):                                                                    Lynge et al.
                                                        National population                                                         No information on employment status
          18,969 men and women employed as petrol
                                                                              All malignant neoplasms                                                                       (1997)
                                                        of gainfully                                       SIR = 1.1 (1.0-1.1)      before or after the census date and
          station attendants on the day of the 1970
                                                                              Cancer of the nose
                                                        employed                                           SIR = 3.1 (1.5-5.7)      hence no adjustment for person-years
          censuses in Denmark, Norway, Sweden and
                                                                              Lung cancer                  SIR = 1.3 (1.1-1.4)      at risk
          Finland and followed up for deaths and
                                                                              Non-Hodgkin's lymphoma       SIR = 1.1 (0.8-1.5)
          incident cancer cases for 15-20 years
                                                                              Hodgkin's disease            SIR = 1.0 (0.5-1.8)
                                                                              Multiple myeloma             SIR = 0.6 (0.3-1.1)
                                                                              Leukaemia                    SIR = 0.9 (0.6-1.3)

                                                                              Female workers (n = 2445):




85
                                                                              All malignant neoplasms      SIR = 1.0 (0.8-1.1)
                                                                              Cancer of the nose           SIR = 8.0 (1.0-28.9)
                                                                              Non-Hodgkin's lymphoma       SIR = 0.6 (0.0-2.0)
                                                                              Hodgkin's disease            SIR = IC
                                                                              Multiple myeloma             SIR = IC
                                                                              Leukaemia                    SIR = 0.7 (0.1-2.4)

                                                                              All-cause mortality, all
                                                        Regional                                                                                                            Lagorio et al.
                                                                                                           SMR <1.00 (p <0.05)      Benzene exposure levels were reported
          2665 petrol station workers in the Latium
                                                                              cancer, and CV disease
                                                        population                                                                                                          (1994a)
                                                                                                                                    to be in the order of 0.2 ppm
          (greater Rome) region in Italy in 1980 and
          followed up for 10 years
                                                                              All CBLS                     SMR = 0.40 (0.07-1.26)
                                                                              All-cause mortality,
                                                        Regional                                                                                                            Rushton
                                                                                                           SMR <1.00 (p <0.05)
          23,306 workers employed for 1 continuous
                                                                              respiratory, liver and
                                                        populations                                                                                                         (1993b)
          year between 1950-75 at UK oil distribution
                                                                              kidney disease, all cancer
          centres and followed up for 15-40 years
                                                                              and cancer of the
                                                                              oesophagus, lung and
                                                                              pleura
                                                                              Leukaemia                    SMR = 1.08 (0.83-1.40)

                                        Table 11.4: Continued
                                                                                        Controls                                                Ratio (95% CI)            Comments                                    Reference
                                       Exposed population                                                      Health outcome*

                                       Petrol and petroleum distribution: Continued
                                                                                                               All-cause mortality,
                                                                                        National population                                                                                                           Wong et al.
                                                                                                                                             SMR <1.00 (p <0.01)
                                       18,135 US workers employed for 1 year
                                                                                                               all cancer and circulatory,                                                                            (1993)
                                       at land-based petrol terminals or on marine
                                                                                                               respiratory and liver disease
                                       petrol tankers from 1946-1985 and followed
                                       up for 5-55 years
                                                                                                               Leukaemia                        SMR = 0.89 (0.59-1.29)    Land-based workers
                                                                                                                                                SMR = 0.70 (0.42-1.09)    Marine workers
                                                                                                               Lymphoma                         SMR = 0.75 (0.58-0.97)    Land-based workers
                                                                                                                                                SMR = 0.61 (0.43-0.83)    Marine workers




                                       Petroleum production, refining and distribution
                                                                                                               All-cause mortality, all CV                                                                            Consonni et al.
                                                                                                                                                SMR <1.00 (p <0.05)       Limited monitoring data indicate that a
                                       1583 workers ever employed at an Italian refinery National population
                                                                                                               disease, stroke, respiratory                                                                           (1999)
                                                                                                                                                                          substantial fraction of the workforce had
                                       from 1949-82 and followed up for
                                                                                                               disease, liver, and GI                                     been exposed to benzene levels >1 ppm
                                       10-42 years
                                                                                                               disease




  86
                                                                                                               CBLS (all workers)               SMR = 1.79 (1.00-2.95)
                                                                                                               CBLS (employment >15             SMR = 2.71 (1.09-5.59)
                                                                                                               years) Leukaemia                 SMR = 3.77 (1.01-9.65)
                                                                                                               (employment >15 years)
                                                                                                               CBLS (employment pre-            SMR = 2.82 (1.13-5.81)
                                                                                                               1961)
                                                                                                               Lymphoma (employment             SMR = 4.02 (1.08-10.28)
                                                                                                               pre-1961)

                                                                                                               All-cause mortality,
                                                                                        National population                                                                                                             Health Watch
                                                                                                                                                SMR <1.0 (p <0.05)        Elevated incidence of leukaemia mainly
                                       15,732 male workers employed for 5 years
                                                                                                               ischaemic heart disease,                                                                                 (1998)
                                                                                                                                                                          accounted for by refinery and terminal
                                       in the Australian petroleum industry from
                                                                                                               stroke, and respiratory, liver                             workers; no definite relationship with length
                                       1981-96 and followed up for 5-15 years
                                                                                                               and GI disease                                             of employment
                                                                                                               Bladder cancer                   SIR = 1.4 (1.0-1.9)       Estimated long-term benzene exposure
                                                                                                               Multiple myeloma                 SIR = 1.9 (1.0-3.3)       levels were 5 ppm in all cases; estimated
                                                                                                               Leukaemia                        SIR = 2.0 (1.3-2.9)       cumulative exposures ranged from 0.005-
                                                                                                               Lymphocytic leukaemia            SIR = 2.0 (1.0-3.5)       50.9 ppm-years (Glass et al, 1998)
                                                                                                               Myeloid leukaemia                SIR = 2.2 (1.2-3.6)

                                                                                                               Melanoma                         SIR = 1.6 (1.3-1.9)       No excess mortality from melanoma (SMR
                                                                                                                                                                          = 0.7 (0.4-1.4)




Priority Existing Chemical Number 21

            Table 11.4: Continued
                                                          Controls                                                 Ratio (95% CI)           Comments                                    Reference
           Exposed population                                                   Health outcome*




 Benzene
           Petroleum production, refining and distribution: Continued
                                                          National population                                                                                                           Järvholm et al.
           4319 Swedish refinery operators and                                  All male workers (n = 4128):
                                                                                                                                                                                        (1997)
                                                                                All-cause mortality, CV disease, SMR <1.00 (p <0.05)
           distribution workers employed for 1 year
                                                                                and lung cancer
           between 1958-91 and followed up for
           5-35 years
                                                                                Refinery operators (n = 1339):
                                                                                Leukaemia                          SIR = 3.6 (1.5-7.0)
                                                                                Distribution workers (n = 1391):
                                                                                All cancer and lung cancer         SIR <1.00 (p <0.05)
                                                                                Leukaemia                          SIR = IC (0-2.0)

                                                                                                                                                                                        Lewis et al.
                                                          National population                                                               There was an increase in multiple
                                                                                Male workers (n = 26,322):
           34,560 workers employed 1 year in refinery,
                                                                                                                                                                                        (2000)
                                                                                                                                            myeloma (SMR = 1.94 (1.11-3.15)) in
                                                                                All-cause mortality, endocrine,    SMR <1.00 (p <0.05)
           petrochemical, distribution, marketing,
                                                                                                                                            marketing and distribution workers
                                                                                circulatory, respiratory and GI
           production, drilling and pipeline locations
                                                                                disease, all cancer
           throughout Canada from 1964-83 and
                                                                                Leukaemia                          SMR = 0.89 (0.67-1.16)
           followed up for 11-31 years
                                                                                Aortic aneurysm                    SMR = 1.27 (1.04-1.53)
                                                                                Female workers (n = 8238):




87
                                                                                All-cause mortality, endocrine,    SMR <1.00 (p <0.05)
                                                                                circulatory, respiratory and GI
                                                                                disease
                                                                                Leukaemia                          SMR = 0.86 (0.32-1.88)

                                                                                                                                                                                        Nelson et al.
                                                          National population   All-cause mortality, all cancer    SMR <1.00 (p <0.05)
           9187 male workers employed for 6 months
                                                                                                                                                                                        (1987)
                                                                                and CV, respiratory and GI
           at 10 US refineries from 1970-80 and
                                                                                disease
           followed up for 2-12 years

                                                                                All CBLS                           SMR = 0.60 (0.34-0.97)

                                                                                                                                            10/11 deaths from skin cancer were due to
                                                                                Skin cancer                        SMR = 2.01(1.00-3.60)
                                                                                                                                            melanoma

                                                                                                                                                                                          Pukkala (1998)
                                                          National population                                                               The breast cancer cases were
                                                                                All workers:
           9454 workers employed for 3 months in 3
                                                                                                                                            concentrated among clerical workers
                                                                                Kidney cancer                      SIR = 1.97 (1.29-2.88)
           refineries, 1 petrochemical plant and the
                                                                                                                                            (SIR = 1.70 (1.08-2.56)), particularly in the
                                                                                Male workers (n = 7512):
           head office of an oil company in Finland
                                                                                                                                            head office (SIR = 2.29 (1.25-3.84)), and
                                                                                Non-Hodgkin's lymphoma             SIR = 2.01 (1.00-3.59)
           from 1967-82 and followed up for 13-28 years
                                                                                                                                            the SIRs did not differ from those found in
                                                                                                                                            other studies of Finnish women in office
                                                                                Female workers (n = 1942):
                                                                                                                                            jobs
                                                                                Breast cancer                      SIR = 1.50 (1.05-2.08)

                                        Table 11.4: Continued
                                       Exposed population                              Controls                                           Ratio (95% CI)            Comments                                   Reference
                                                                                                              Health outcome*

                                       Petroleum production, refining and distribution: Continued
                                                                                                                                            SMR <1.00 (p <0.05)     The SMR for melanoma was not elevated Rushton
                                                                                                              All-cause mortality, stroke
                                       34,569 men employed at 8 UK refineries for 1 Regional populations
                                                                                                                                                                    in workers first employed before 1955, but (1993a)
                                                                                                              all heart, respiratory and
                                       continuous year between 1950-75 and followed
                                                                                                                                                                    reached 2.30 (1.05-4.37) and 4.67 (2.02-
                                                                                                              liver disease, all cancer and
                                       up for 15-40 years
                                                                                                                                                                    9.20) in workers first employed between
                                                                                                              cancer of the mouth,
                                                                                                                                                                    1955-64 and after 1965 respectively. It
                                                                                                              pharynx, lung and pleura
                                                                                                                                                                    varied markedly between refinery locations
                                                                                                                                          SMR = 1.20 (1.07-1.35)    and was higher among office staff than in
                                                                                                              Diseases of the arteries
                                                                                                                                          SMR = 0.97 (0.76-1.24)    workers employed outdoors.
                                                                                                              Leukaemia
                                                                                                                                          SMR = 1.78 (1.20-2.54)
                                                                                                              Melanoma

                                                                                      UK national                                                                                                           Thorpe (1974)
                                                                                                                                          SMR = 0.77 (0.41-1.13)
                                                                                                              All leukaemias
                                       Workers representing 383,276 man-years of                                                                                    In a subgroup of workers exposed for 5
                                       employment in 1962-71 at 8 European affiliates population                                                                    years to streams containing 1% benzene,
                                       of a US oil company                                                                                                          the SMR for leukaemia was 1.21 (0.37-
                                                                                                                                                                                                               Wong & Raabe
                                                                                                                                          MSMR = 1.02 (0.93-1.11)   Meta-analysis of leukaemia mortality by
                                                                                                              All leukaemias
                                       Meta-analysis of 19 cohorts comprising 208,741 Various national and
                                                                                       regional populations                                                                                                    (1995); Raabe
                                                                                                                                          MSMR = 1.16 (0.81-1.61)   cell type; no data on other death rates
                                                                                                              Acute lymphocytic
                                       refinery, production, pipeline and distribution
                                                                                                                                                                                                               & Wong (1996)
                                                                                                              leukaemia
                                       workers ever employed in USA and UK from
                                                                                                                                          MSMR = 0.96 (0.81-1.13)
                                                                                                              Acute myeloid leukaemia
                                       1937-1989 and followed up for 13-50 years




  88
                                                                                                                                          MSMR = 0.84 (0.67-1.04)
                                                                                                              Chronic lymphocytic
                                                                                                              leukaemia
                                                                                                                                          MSMR = 0.89 (0.68-1.15)
                                                                                                              Chronic myeloid leukaemia

                                                                                       Various national and                                                                                                    Wong & Raabe
                                                                                                                                          MSMR = 0.90 (0.82-0.98)
                                                                                                              Non-Hodgkin's lymphoma
                                       Meta-analysis of 26 cohorts comprising
                                                                                       regional populations                                                                                                    (2000)
                                       more than 308,000 refinery, production and
                                       distribution workers ever employed in
                                       Australia, Canada, Finland, Italy, USA
                                       and UK from 1937-1996

                                       Printing
                                                                                       National population                                                                                                     Paganini-Hill et
                                                                                                                                          SMR = 3.03                Exposed to printing inks and solvents
                                                                                                              Kidney cancer
                                       1361 men ever employed as rotary press
                                                                                                                                                                                                               al. (1980)
                                                                                                                                          SMR = 2.05                containing benzene
                                                                                                              Liver cirrhosis
                                       workers in Los Angeles from 1949-65 and
                                                                                                                                          SMR = 2.47                No analysis for statistical significance
                                                                                                              Leukaemia
                                       followed up till 1980

                                       Tyre manufacturing
                                                                                       National population                                                                                                     McMichael et
                                                                                                                                          SMR <1.00                 No exposure assessment, but `benzene
                                                                                                              All-cause mortality
                                       18,903 male workers employed for 10 years
                                                                                                                                                                                                               al. (1976)
                                                                                                                                          SMR = 1.48/1.16/1.19      was once the most widely used organic
                                                                                                              Stomach/colon/prostate
                                       at 4 tyre manufacturing plants in Ohio and
                                                                                                                                                                    solvent in the industry'
                                                                                                              cancer
                                       Wisconsin, USA, from 1945-1964 and
                                                                                                                                          SMR = 1.31                No analysis for statistical significance
                                                                                                              CBLS
                                       followed up for 10 years




Priority Existing Chemical Number 21
                                                                                                                                          SMR = 1.30
                                                                                                              Leukaemia
                                                                                                                                          SMR = 1.58
                                                                                                              Lymphocytic leukaemia
                                                                                                                                          SMR = 1.29
                                                                                                              Lymphoma

             Table 11.4: Continued




Benzene
          Exposed population                             Controls                                           Ratio (95% CI)             Comments                                 Reference
                                                                                Health outcome*

          Vehicle mechanics
                                                                                 All-cause mortality and
          335 predominantly black men employed for       Regional population                                                                                                    Hunting et al.
                                                                                                            SMR <1.00 (p <0.05)        Regular contact workers used petrol to
                                                                                 liver and GI disease                                                                           (1995)
                                                                                                                                       clean engine parts and wash hands or
          1 year as vehicle maintenance workers in
                                                                                 CBLS (all workers)         SMR = 3.63 (0.75-10.63)    siphoned petrol by mouth
          Washington, DC, from 1977-89 and
                                                                                 CBLS (regular contact      SMR = 9.26 (1.12-33.43)
          followed up for 3-15 years
                                                                                 workers)



          Miscellaneous industries

                                                                                All-cause mortality and
          74,828 male and female workers employed        35,805 unexposed                                                                                                       Yin et al.
                                                                                                            No difference
                                                                                all cancer deaths
          from 1972-87 in the painting, printing,        workers                                                                                                                (1996)
                                                                                Fatal CBLS
          footwear and chemical industries in                                                               RR =  (2.5-)
                                                                                Fatal leukaemia
          China and followed up for 1-15 years                                                              RR = 2.3 (1.1-5.0)
                                                                                Fatal lymphoma              RR = 4.5 (1.3-28.4)




89
          * CBLS = cancer of the blood and lymphatic system; CV = cardiovascular; GI = gastrointestinal; GU = genitourinary.
          
            IC = incalculable (no observed cases); MSRM = meta-SMR; SIR = standardised incidence ratio; SMR = standardised mortality
          ratio; RR = relative risk;  = indefinite (no cases in the unexposed group).

Cohort studies with detailed benzene exposure assessments

There are four occupational cohort studies in which the exposure to benzene has
been assessed in detail.

The Chinese cohort

The US National Cancer Institute and the Chinese Academy of Preventive
Medicine have collaborated to follow up on a large cohort study commenced in
1982 to assess the risks of specific bone marrow disorders in relationship to
occupational benzene exposure (Hayes et al, 1997). The final cohort comprises
74,828 male and female benzene-exposed workers employed from 1972 to 1987 in
672 factories in 12 cities in China and 35,805 unexposed workers. The subjects
were followed until the end of 1987, for an average of approximately 11 years. RRs
were determined for incident cancer of the blood and lymphatic system, NHL,
leukaemia, ANLL, a diagnosis of either ANLL or MDS, and leukaemia other than
ANLL, with stratification by age and sex. Smoking or other potential confounders
were not considered. The exposed workers held permanent jobs in the painting,
printing, footwear, rubber and chemical industries. Exposure levels were estimated
from available area monitoring data, detailed production and process information,
and employee records.
There were 58 specified cancers of the blood and lymphatic system and 18 other
bone marrow disorders (2 cases of agranulocytosis, 9 of aplastic anaemia and 7 of
MDS) in the cohort, compared to 13 and 0 respectively in the control group.
When the cohort was divided into three categories according to the estimated
average benzene exposure level, the RRs for all cancer of the blood and lymphatic
system and ANLL/MDS were elevated in all categories, with a positive trend for
increasing average exposure, as shown below:
                                  Estimated average exposure:
Cancer type/R:         <10 ppm              10-24 ppm            >25 ppm              Trend
Blood and
lymphatic system      2.2 (1.1-4.2)         3.1 (1.5-6.5)      2.8 (1.4-5.7)        p = 0.003
ANLL/MDS             3.2 (1.0-10.1)      5.8 (1.8-18.8)       4.1 (1.2-13.2)        p = 0.01

The RR for NHL was 4.7 (1.2-18.1) in workers exposed to 25 ppm, but was not
elevated in the lower average exposure categories.
When the cohort was divided into three categories according to the estimated
cumulative benzene exposure level, the RR for all cancer of the blood and
lymphatic system was elevated in all categories, whereas the RRs for leukaemia
and ANLL/MDS were elevated at cumulative exposures 40 ppm-years:
                                 Estimated cumulative exposure
                                                                                      Trend
Cancer type/RR       <40 ppm-years     40-99 ppm-years       100 ppm-years
Blood and
lymphatic system      2.2 (1.1-4.5)         2.9 (1.3-6.5)      2.7 (1.4-5.2)        p = 0.004
Leukaemia             1.9 (0.8-4.7)         3.1 (1.2-8.0)      2.7 (1.2-6.0)        p = 0.04
ANLL/MDS              2.7 (0.8-9.5)      6.0 (1.8-20.6)       4.4 (1.4-13.5)         p = 0.01

The RR for NHL was not elevated in any of the three cumulative exposure
categories.


                                                            Priority Existing Chemical Number 21
                                       90

          Only NHL was linked to duration of exposure. None of the RRs were related to the
          year of initial employment in the study factories. ANLL/MDS was linked to recent
          exposure (<10 years prior to diagnosis), whereas NHL was linked to distant
          exposure (10 years prior to diagnosis).
          The authors concluded that the results suggest an association between benzene
          exposure and a spectrum of blood cancers and related disorders, with an increase in
          cancer risk at cumulative exposures <40 ppm-years and a tendency, although not
          strong, for the risk to rise with increasing levels of exposure.
          It should be noted that personal monitoring in a subset of the Chinese cohort
          measured current exposure levels which were reported to be `much higher than
          expected' compared to the estimates that were made in the course of the main study
          (Rothman et al, 1995, 1996b). As such, the historical exposure levels used to
          determine the dose-response relationship may have been grossly underestimated
          (Budinsky et al, 1999; EPA, 1998a; Wong, 1999).
          Overall mortality rates in the Chinese cohort have been reported by Yin et al.
          (1996) and are summarised in Table 11.4. The average latency period of fatal
          leukaemia in benzene-exposed workers was estimated at 11-12 years, with a range
          from 10 months to 50 years (Yin et al, 1987b).

          The CMA cohort

          The Chemical Manufacturers Association (CMA) sponsored a study of 4602 male
          chemical workers who were employed for 6 months from 1946-75 at 7 US plants
          (Wong, 1987a, 1987b). Two comparison groups were used: the general US
          population and 3074 unexposed male workers employed at the same plants at the
          same time as the cohort. Smoking or other potential confounders were not
          considered. The vital status of all subjects was followed up until the end of 1987
          and the findings compared to average and peak exposures as determined from
          available air monitoring data and employment records obtained from the
          participating companies.
          There were 19 deaths from cancer of the blood and lymphatic system in the
          exposed workers compared to 3 in the unexposed group. In the exposed group, 7 of
          the observed cases were diagnosed with leukaemia and the remaining 12 with
          lymphoma. The subjects with leukaemia comprised 1 case with acute lymphatic
          leukaemia (ALL), 2 with chronic lymphatic leukaemia (CLL), 1 with unspecified
          lymphatic leukaemia, 2 with chronic myeloid leukaemia (CML) and 1 with
          unspecified acute leukaemia. In the unexposed workers, all 3 cases were diagnosed
          with lymphoma. The SMRs for all cancers of the blood and lymphatic
          system/leukaemia reached 0.91/0.97, 1.47/0.78 and 1.75/2.76 for cumulative
          exposures of <180, 180-719 or 720 ppm-months respectively, but none of the
          ratios was significantly different from unity. The RRs for all cancers of the blood
          and lymphatic system were 2.10, 2.95 and 3.93 respectively for the same
          cumulative exposure groups, with p = 0.02 for trend. The RRs for leukaemia were
          indefinite as there were no cases in the unexposed workers, with p = 0.01 for trend
          with cumulative exposure. There was no correlation with peak levels or duration of
          exposure.
          Based on the RRs and their trend with cumulative exposure, the author concluded
          that workers exposed to benzene exhibited a significant excess of deaths from
          leukaemia as well as from the broader category of all cancers of the blood and


Benzene                                       91

lymphatic system when compared with workers who were not exposed to the
chemical.
Ireland et al. (1997) conducted an extended mortality study in production personnel
from one of the plants included in the CMA-sponsored study. The workers were
stratified into three categories based on cumulative exposure: <12 ppm-months (n =
666), 12-72 ppm-months (n = 378) and 72 ppm-months (n = 164). Compared to
the regional population, the SMR for leukaemia was 2.5 (0.3-8.9) in the lowest,
incalculable (0.0-5.9) in the middle, and 4.6 (0.9-13.4) in the highest exposure
category, with no clear dose-response relationship.

The Dow Chemical cohort

This cohort comprised 956 male chemical workers employed at a single site in
Michigan, USA, between 1940 and 1982. The workers were exposed to benzene in
chlorobenzene or alkylation plants which used benzene as a raw material, or in an
ethyl cellulose plant where benzene was used as a solvent (Bond et al, 1986; Ott et
al, 1978). They were followed up until the end of 1982. The average exposure
duration and length of follow-up were 7 and 26 years respectively. Each job entry
was assigned an exposure intensity level on the basis of job classification and
representative personal air monitoring data.
The analysis accounted for co-exposure to arsenic, asbestos or high levels of vinyl
chloride. Smoking or other potential confounders were not considered. There were
6 deaths from cancer of the blood and lymphatic system against 4.8 expected,
including 4 cases of myelogenous leukaemia against 0.9 expected, and 4 from skin
cancer (3 melanomas and 1 squamous cell carcinoma) against 0.9 expected, using
concurrent US white male mortality rates as reference values. The excess of
myelogenous leukaemia was statistically significant (p = 0.011; SMR and 95% CI
not stated) and the risk for skin cancer was significantly elevated (SMR = 4.41
(1.21-11.38)). There were no significant trends with either work area, cumulative
exposure or duration of exposure. Of the 6 cases of blood and lymphatic system
cancer, 4 had been exposed to <500 ppm-months and 2 to 1000 ppm-months. In
the case of myelogenous leukaemia, cumulative exposures varied from 18-4211
ppm-months. The 4 cases of skin cancer all occurred in workers with exposures
<500 ppm-months, but otherwise had no unusual or common characteristics.
The authors concluded that their study provided support for an association between
exposure to benzene and myelogenous leukaemia.

The Pliofilm cohort

An excess incidence of leukaemia in rubber workers at two Goodyear facilities in
Ohio, USA was reported in a preliminary paper by Infante et al. (1977) and in more
detail by Rinsky et al. (1981). Depending on its definition, this cohort comprises
1165-1212 male workers employed from 1936-75 in the manufacture of Pliofilm,
which is a material made from rubber hydrochloride (Paxton et al, 1994a; Rinsky et
al, 1987). The manufacturing process used large volumes of benzene as a solvent
and there was no exposure to other known carcinogenic substances. The last worker
joined the cohort in 1965 and the most recent follow-up was in 1987.
Excluding deaths before 1950, Rinsky et al. (1987) identified 15 deaths from
lymphatic and haematopoietic cancers versus 6.6 expected (SMR = 2.27 (1.27-
3.76)) and 9 deaths from leukaemia versus 2.7 expected (SMR = 3.37 (1.54-6.41)).
In a later analysis that included deaths between 1940-50, Paxton et al. (1994a)

                                                      Priority Existing Chemical Number 21
                                    92

          identified 21 deaths from lymphatic and haematopoietic cancers versus 9.51
          expected (SMR = 2.21 (1.37-3.38)) and 14 deaths from leukaemia versus 3.89
          expected (SMR = 3.60 (1.97-6.04)). Neither of these analyses considered smoking
          or other potential confounders.
          The individual exposure histories of the cohort members were reconstructed after
          the plants closed in 1975, from fairly detailed monitoring and health surveillance
          data and other information on record.
          Based on unpublished exposure estimates, Rinsky et al. (1987) found SMRs for
          leukaemia of 1.09 (0.12-3.94) at a cumulative exposure <40 ppm-years, 3.22 (0.36-
          11.65) at 40-200 ppm-years, 11.86 (1.33-42.85) at 200-400 ppm-years and 66.37
          (13.34-193.93) at >400 ppm-years.
          Paxton et al. (1994a) recalculated the SMRs for a different set of cumulative
          exposure categories and compared them with similar statistics derived from
          independent, more detailed exposure estimates produced by Crump & Allen
          (unpublished report prepared for the Occupational Safety and Health
          Administration in 1984) and Paustenbach et al. (1992), as shown in Table 11.58.
          The results reproduced in the table suggest a strong dose-response relationship of
          risk increasing with cumulative exposure, no matter which estimate is used, and
          indicate that there is a significantly elevated risk for leukaemia (according to 2 of
          the 3 available exposure estimates) at a cumulative dose >50 ppm-years,
          corresponding to a long-term average exposure of 1.25 ppm over 40 years.

          Table 11.5: SMRs (95% CI) for leukaemia in the Pliofilm cohort, analysed by
          cumulative exposure as estimated by Crump & Allen (1984, unpublished),
          Paustenbach et al. (1992) and Rinsky et al. (1987)(from Paxton et al, 1994a)

          Cumulative                                        Exposure estimate
          exposure
          (ppm-years)             Crump & Allen            Paustenbach et al.             Rinsky et al.
                 0-5              0.88 (0.02-4.89)           1.33 (0.03-7.43)            1.97 (0.41-5.76)
                >5-50             3.25 (0.88-8.33)           1.79 (0.22-6.45)            2.29 (0.47-6.69)
                                                                                        6.93 (2.78-14.28) 
              >50-500            4.87 (1.79-10.63)*          2.80 (0.76-7.16)
                                10.34 (2.13-30.21)         11.86 (4.76-24.44) 
                >500                                                                   20.00 (0.51-111.4)

          * p <0.05
          
            p <0.01


          As the SMR was not significantly different from unity at cumulative exposures 50
          ppm-years for any of the three exposure estimates, the authors concluded that the
          results of the analysis were consistent with a threshold model for benzene-induced
          leukaemia. However, the power of the analysis was insufficient to support this
          conclusion. The upper 95% confidence limits given in Table 11.5 range from 6.45-
          8.33 in the >5-50 ppm-year exposure category and from 4.89-7.43 the 0-5 ppm-
          year category. In either case, the upper limits are well above unity irrespective of
          the exposure estimate used. Therefore, it cannot be excluded that a cumulative
          exposure level 50 ppm-years is also associated with an excess mortality from
          leukaemia.


          8
            The major distinction between the three exposure estimates is the disregard by Rinsky et al. (1987)
          for the likely increase in exposure levels during and in the aftermath of World War II because of
          wartime conditions and longer working hours. In addition, only Paustenbach et al. (1992) have given
          consideration to the potential for dermal exposure.
Benzene                                               93

Wong (1995) reanalysed the findings of Paxton et al. (1994a) by cell type (AML
and multiple myeloma (MM)), using the Rinsky et al. (1987) exposure estimate
which in general is the lowest of the three. He found no relationship between
cumulative exposure and the risk of MM, whereas the SMR for AML showed a
clear dose response, as follows:
      Cumulative exposure            SMR (95% CI)          Statistical significance
         <200 ppm-years          0.91 (0.02-5.11)                Not significant
       200-400 ppm-years        27.21 (3.29-98.24)                  p <0.01
         >400 ppm-years        98.37 (20.28-287.65)                 p <0.01
            Total cohort         5.03 (1.84-10.97)                  p <0.01

The author concluded that there was no significant increase in the risk of AML for
cumulative exposure to benzene <200 ppm-years, above which the risk rose sharply
to a very substantial SMR of 98.37 for >400 ppm-years. However, as the 95%
upper confidence limit in the lowest exposure group was 5.11, an increase in
mortality from AML at a cumulative exposure <200 ppm-years cannot be ruled out.
In another re-analysis based on the three sets of exposure estimates referred to
above, Schnatter et al. (1996b) used the work history of each Pliofilm worker to
define each worker's maximally exposed job/department combination over time
and the long-term average benzene exposure level associated with the maximally
exposed job. They then determined the number of observed and expected cases of
leukaemia (all cell types) in subcategories of workers and person-years who were
always exposed at levels that did not exceed specific concentrations of benzene. As
shown in Table 11.6, this analysis showed that there were fewer observed than
expected deaths in all subcategories that were always exposed to benzene
concentrations 15 ppm, irrespective of the exposure estimate used. However,
because of the low number of expected cases, this finding could also be due to
chance.

Table 11.6: Observed and expected cases of leukaemia (all cell types) for
selected cut-off points for the average long-term exposure level in the
maximally exposed job (Schnatter et al, 1996b)

Long-term                                   Exposure estimate
benzene
                     Crump & Allen          Paustenbach et al.          Rinsky et al.
exposure
(ppm)             Observed   Expected Observed        Expected Observed        Expected
     1                0       0.53            0        0.07            1           1.53
     5                0       1.01            0        0.10            1           1.72
     10               0       1.04            0        0.11            1           2.00
     15               0       1.28            0        0.15            1           2.00
     20               2       1.92            0        0.21            3           2.30
     25               2       2.13            1        0.80            7           2.92
     30               3       2.35            1        0.90            7           3.24
     40               5       2.73            1        1.33           10           4.04
     50               5       2.98            3        1.96           14           4.79
    100               8       3.98            5        3.55           14           4.87
    200               9       4.20           14        4.70           14           4.87
    260               14      4.87           14        4.87           14           4.87




                                                         Priority Existing Chemical Number 21
                                       94

          Conclusions

          Cohort studies with poorly characterised benzene exposure levels

          Several of the studies summarised in Table 11.4 have associated cancer of the
          blood and lymphatic system (including but not limited to leukaemia) with the
          obsolete practice of using benzene-containing adhesives, cleaners and solvents.
          Some studies indicate a positive association with long-term employment at
          petroleum refineries, in the chemical industry or in highway maintenance. There
          was no excess mortality from leukaemia in three cohorts of coke plant workers.
          The risk for malignant melanoma or skin cancer (mainly melanoma) was elevated
          in three petroleum industry cohorts (Health Watch, 1998; Nelson et al, 1987;
          Rushton, 1993a). The SIR for breast cancer was elevated in female workers in a
          Finnish oil company cohort (Pukkala, 1998). However, the elevation was mainly
          due to cases among clerical workers and similar in magnitude to that found in other
          studies of Finnish women in office jobs.

          Cohort studies with detailed benzene exposure assessments

          There was an excess mortality from cancer of the blood and lymphatic system in all
          four cohorts for which detailed benzene exposure assessments are available and a
          significant trend with cumulative exposure in all but the smallest cohort (the Dow
          Chemical cohort). As such, it is widely accepted that these studies provide
          sufficient evidence of a clear dose-response relationship between benzene exposure
          and the broad category of all cancers of the blood and lymphatic system (ATSDR,
          1997; OECD, 2000; IARC, 1982a; IPCS, 1993; USEPA, 1998a). In terms of
          specific cancer categories, the relationship is primarily due to the risk for AML
          (ANLL).
          In the CMA cohort, the SMR for leukaemia was elevated (2.6) in workers with a
          cumulative exposure of 720 ppm-months (that is, 60 ppm-years), but it was not
          significantly different from unity and therefore could have been due to chance. In a
          subset of the CMA cohort, the SMR for leukaemia was 4.6 in workers with a
          cumulative exposure of 72 ppm-months (6 ppm-years), but again did not differ
          significantly from unity. There was no clear dose-response relationship in the Dow
          Chemical cohort and there is doubt about the true exposures in the Chinese cohort.
          As such, the Pliofilm cohort is the most suitable for the determination of the
          carcinogenic potency of benzene. In addition, the Pliofilm cohort has the advantage
          of limited if any co-exposure to other potentially carcinogenic compounds and a
          very long follow-up period. However, it suffers from uncertainty about actual
          exposure levels, particularly prior to 1950, which is important as there are no cases
          of leukaemia in workers first employed after that year (USEPA, 1998a).
          Based on an unpublished assessment of individual exposures in the Pliofilm cohort,
          Rinsky et al. (1987) determined SMRs for leukaemia that increased exponentially
          with cumulative exposure, starting from near unity at a cumulative exposure <40
          ppm-years. More recent dose-response analyses that include other, more
          comprehensive exposure assessments indicate that the risk for leukaemia is
          significantly elevated at a cumulative exposure level above, but not below 50 ppm-
          years, corresponding to an average exposure level of 1.25 ppm over 40 years
          (Paxton, 1994b). Moreover, whatever exposure estimate was used, the number of
          observed cases of leukaemia was consistently below the expected number in all
          workers whose long-term exposure never exceeded 15 ppm (Schnatter et al,
          1996b). However, because of the limited statistical power resulting from the size of
Benzene                                        95

       the Pliofilm cohort, these results do not rule out the possibility of an increased risk
       of leukaemia at exposure levels lower than those cited above.
       In the Dow Chemical cohort, there was an association between benzene exposure
       and skin cancer. However, all cases occurred in the lowest cumulative dose group
       (<500 ppm-months) and there was no trend with either level or duration of
       exposure.

11.6.2 Case-control studies
       The case-control studies reviewed below have been divided by organ system. They
       comprise studies based in a specific industry, such as petroleum refining, and
       studies conducted in a community population. Limitations in statistical power and
       study quality, particularly in relation to exposure assessment and/or control for
       potential confounders, pervade all of the studies reviewed.

       Cancer of the blood and lymphatic system

       Industry-based studies

       A study nested within a cohort of male workers at a large tyre manufacturing plant
       in Ohio, USA included 11 cases of lymphocytic leukaemia and 1350 controls
       (Checkoway et al, 1984). The OR for direct exposure through routine use or
       handling of benzene or benzene-containing solutions was 4.50 (95% CI not stated),
       but did not reach statistical significance (p = 0.22). The ORs for exposure to
       acetone, carbon disulfide, carbon tetrachloride, ethyl acetate, hexane or methanol
       ranged from 4.3-18 (95% CIs not stated) and were all statistically significant.
       Austin et al. (1986) compared 14 cases of leukaemia in white male workers at a US
       refinery, including 8 cases of AML, with 50 controls. Neither job category,
       department nor length of employment was a significant risk factor.
       In an exploratory study of cancer mortality at a transformer assembly facility in
       Massachusetts, USA, where benzene was used for general cleaning purposes until
       1950, benzene exposure was not a significant risk factor for leukaemia (OR = 1.4
       (0.64-3.2)) (Greenland et al, 1994).
       Sathiakumar et al. (1995) studied 69 workers with leukaemia, predominantly AML
       or CLL (numbers not specified), and 284 controls who had worked for the same
       US-based petroleum company for 1 year from 1976-90. Forty-four risk factors
       tested for included site of work, involvement in production, job category, duration
       and year of employment. The only risk factors identified were for AML and
       included length of employment, with an OR = 8.7 (2.0-37.2) in workers employed
       for >30 years (trend: p = 0.01), and upstream employment in crude oil production
       or maintenance (OR = 3.2 (1.1-9.2)).
       Schnatter et al. (1996a) compared 7 cases of NHL, 7 cases of MM and 55 controls
       drawn from the cohort of Canadian petroleum distribution workers described by
       Lewis et al. (2000). Tests included several measures for benzene exposure. The
       only risk factors identified were a family history of cancer and cigarette smoking,
       with cumulative benzene exposure showing no additional risk.
       A study nested in the cohort of British petroleum distribution and marketing
       workers described by Rushton (1993b) compared 91 cases of leukaemia,
       predominantly ANLL (31) and CLL (31), with 364 controls (Rushton & Romaniuk,
       1997). Risk factors tested for included cumulative, mean and maximum airborne

                                                                Priority Existing Chemical Number 21
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          and potential skin exposure to benzene, duration of employment, date of hire,
          employment as driver, socio-economic status, and age at and years from start of
          work. For ANLL, none of the ORs differed from unity. For CLL, the risk factors
          identified included duration of employment, white-collar status and years of work,
          but not exposure to benzene.
          The case-control study nested within the cohort of Australian petroleum industry
          workers currently comprises 63 cases with lympho-haematopoietic cancers, mainly
          NHL, MM, AML and CLL, and 315 controls (Health Watch, 1998). In the analysis,
          the OR was used to compare groups with different levels of exposure to various
          potential causative agents, relative to the least exposed or baseline group.
          Compared to the baseline of the rate in refineries, the OR was marginally elevated
          for work in terminals (1.8 (1.0-3.5)). Length of employment and period of first
          employment were not significant risk factors. Past exposure to benzene was ranked
          on a scale from 1-5, depending on AIP jobcode, the company site where the job
          was carried out and length of service in any job. When cases and controls were
          compared to the highest benzene rank of any job ever held (ranks 4-5), the OR was
          7.9 (1.6-39) times higher than for rank 1 (the baseline). When compared to the
          benzene rank of the job held longest, the OR was 3.2 (1.1-9.4) times higher than
          baseline for rank 3 and 6.6 (1.4-30) times higher for rank 4 (the highest rank in this
          test). The authors concluded that a relatively higher exposure to benzene might be
          the significant factor leading to an increased risk of leukaemia and MM in the
          cohort study.
          Nilsson et al. (1998) conducted a nested case-control study of Swedish seamen with
          two study bases. These comprised a total of 92 men who were registered as seamen
          at the national censuses in Sweden in 1960 and 1970 respectively and recorded in
          the Swedish National Cancer Register with cancer of the blood and lymphatic
          system from 1971-88. The controls were 291 age-matched men registered as
          seamen at the same censuses. NHL (37) and leukaemia (30) accounted for most of
          the cases. There were no increased risks for the 1960 cohort, in which few cases
          were exposed to benzene or petrol. In the 1970 cohort, the OR was increased for
          cancer of the blood and lymphatic system (OR = 2.6 (1.1-5.9)) and for NHL (OR =
          3.3 (1.1-10.6)) in seamen who had worked on deck on chemical or petroleum
          product tankers, but not on crude oil tankers.
          Wong et al. (1999) studied 59 cases of leukaemia, including unspecified leukaemia
          (35), AML (13) and MM (11), and 220 controls drawn from a US-based cohort
          study of 18,135 petrol distribution workers (Wong et al, 1993). Test variables
          included duration of employment, duration of exposure, job category, cumulative
          exposure to hydrocarbons, cumulative frequency of peak exposure to hydrocarbons,
          and year of first exposure. None of these was identified as a risk factor for any of
          the study diagnoses.
          In a study nested within the Pliofilm cohort described above, Finkelstein (2000)
          examined the temporal variation of leukaemia risk following exposure to benzene.
          Each leukaemia case was matched with 6-333 control subjects and the exposure of
          cases and controls were then assessed according to Rinsky et al. (1987) and
          compared at various times before the death of the case subject. As expected,
          leukaemia risk was significantly associated with cumulative exposure (p = 0.024).
          However, exposures incurred in the previous 10 years were found to account for
          most of the risk and there was no significant difference in the benzene exposure of
          cases and controls 15 or more years prior to the death of the case subject.


Benzene                                        97

Community-based studies

Exposure to benzene and/or toluene was investigated in 401 cases of various
serious blood disorders and 124 controls sampled from the same general hospital in
Lyon, France (Girard & Revol, 1970). The prevalence of exposure was
significantly higher among patients with acute leukaemia, CLL and aplastic
anaemia than in the comparison group. The majority of the exposed patients had
worked in small workshops where the main sources of exposure were reported to
be cleaning fluids and paint and glue thinners.
Ishimaru et al. (1971) interviewed 303 matched pairs of controls and cases of
leukaemia (not further specified) with onset from 1945-67 in Hiroshima or
Nagasaki in Japan. The OR was 2.5 (p <0.01) among those with a history of any of
11 occupations with the potential for frequent exposure to benzene or x-rays and
showed a positive trend with the length of time in those occupations.
Eighteen (36%) out of 50 working men with ANLL seen at a hospital in Lund,
Sweden, were occupationally exposed to petroleum products or vehicle exhaust
fumes through occupation as petrol stations attendants, drivers or operators of
excavators or power saws (Brandt et al, 1978). By comparison, similar exposure
patterns occurred in only 10% of three outpatient control groups (p = 0.0002),
including a group of male patients with CML or CLL (p = 0.006), or 10-11% of the
general male population in the region.
Linos et al. (1980) compared 138 cases of acute or chronic leukaemia (not further
specified) that occurred in residents in a county in Minnesota, USA between 1955-
74 with 276 controls, with regard to past occupational and chemical exposure. The
OR for exposure to benzene was not significantly elevated (3.34 (0.60-27.60)).
In a study of 131 cases of MM, 111 cases of CLL and 431 controls resident in a
rural woodland district in central Sweden, Flodin et al. (1987, 1988) observed an
association with occupational exposure to exhaust fumes from diesel and petrol
engines, including tractors and chainsaws. The OR was 2.1 (1.2-3.9) for MM and
2.2 (1.2-4.2) for CLL.
Another Swedish study of 125 cases of acute leukaemia (including 97 AML and 24
ALL cases) and an equal number of controls found a large excess risk for
professional painters exposed to solvents that would have contained benzene as an
impurity (OR = 13 (2-554) (Lindquist et al, 1987). There was also an excess risk
among professional drivers, with an OR = 3.0 (1.1-9.2). The OR reached 5.0 (95%
CI not stated; p <0.05) for those who had been drivers for >5 years in their lifetime
or >1 year during the 5-20-year period prior to diagnosis and remained after
adjustments for exposure to organic solvents, smoking and therapeutic x-ray
treatment (Lindquist et al, 1991).
A study of 475 cases of lymphoma, leukaemia and MM in white male residents in
Missouri, USA, and 1425 controls found an elevated risk of leukaemia in
mechanics (OR = 4.79 (1.42-16.18)) (Brownson & Reif, 1988).
Richardson et al. (1992) conducted an interview study of occupational risk factors
of acute leukaemia in French adults, based on 31 cases of ALL, 154 cases of AML
and 513 controls. A significant relationship was observed between AML and high
or medium exposure to benzene (OR = 3.6 (1.7-7.7)). For ALL and AML
combined, the OR for any exposure to benzene was 1.3 (0.8-2.3), whereas it was
2.8 (1.3-5.9) for high or medium exposure.


                                                       Priority Existing Chemical Number 21
                                     98

          In an interview study of 622 white males with NHL and 1245 controls drawn from
          the general population in Iowa and Minnesota, USA during 1980-83, there were no
          indications that industrial exposures were a major determinant for NHL (Blair et al,
          1993). The OR for benzene exposure was close to unity, but did increase slightly
          with intensity of exposure (lower intensity: OR = 1.1 (0.8-1.4); higher intensity:
          OR = 1.5 (0.7-3.1)).
          In a study of 86 cases of AML, CML or MDS in residents in Turin, Italy, there was
          a marginally elevated risk of leukaemia/MDS in vehicle mechanics (OR = 2.7
          (0.97-7.6)) and truck and other drivers (OR = 2.7 (0.8-9.6)), but no association with
          exposure to benzene (Ciccone et al, 1993).
          A French, hospital-based case-control study of 226 male cases of hairy cell
          leukaemia and 425 matched controls found no association between occupational
          exposure to benzene and this rare B-lymphoid chronic leukaemia (Clavel et al,
          1996).
          A recent review by Savitz & Andrews (1997) identified 12 additional community-
          based case-control studies of benzene and cancer of the blood and lymphatic
          system, none of which reported any association between the two.

          Childhood leukaemia

          Leukaemia is the most common cancer in children under the age of 15 (Shu, 1997).
          A number of case-control studies have explored the potential relationship between
          childhood leukaemia and parental exposure to agents that might be toxic to the
          unborn or breast-fed baby and/or the germ cells of the parents.
          Some of these studies have suggested a link between childhood leukaemia and pre-
          conceptional occupational exposure of the father to solvents, petroleum products,
          motor vehicle exhaust fumes, benzene, or plastic monomers or polymers (Buckley
          et al, 1989; Fabia & Thuy, 1974; McKinney et al, 1991; Shu et al, 1999; Vianna et
          al, 1984). Others have found a weak association with maternal employment in jobs
          with the potential for exposure to various chemicals including benzene, petrol,
          solvents and thinners, paints and/or plastic monomers or polymers (Shu et al, 1988,
          1999; van Steensel-Moll et al, 1985).
          A study of 123 cases of childhood leukaemia and an equal number of matched
          controls found a significant, dose-related elevation in the risk of leukaemia for
          children whose parents burned incense in the house during pregnancy or lactation
          (Lowengart et al, 1987). Incense stick has been reported to emit the same quantity
          of benzene in smoke as tobacco and herbal cigarettes (Löfroth et al, 1991).
          In a study of 97 cases of childhood leukaemia (78 of whom had ALL) and 259
          matched controls from Denver, USA, Pearson et al. (2000) found an association
          between childhood leukaemia and proximal high traffic streets with traffic counts
          20,000 vehicles per day (OR = 8.28 (2.09-32.80)).

          Skin cancer

          In a study of 307 cases of non-melanoma skin cancer (basal and/or squamous cell
          carcinoma) and 229 controls resident in Texas, USA, the most important risk
          factors were red hair, fair skin, outdoor sun exposure, and a family history of skin
          cancer (Gamble et al, 1996). Employment at any time in the petroleum industry
          was associated with a slightly elevated risk of developing concurrent basal and
          squamous cell carcinomas (OR = 2.10 (1.08-4.09)).

Benzene                                        99

In a Dutch study of 140 cases with non-metastasised melanoma and 181 controls
with other types of malignancy, increased risks were found for subjects ever
employed in the electronics, metal and transport and communication industries
(Nelemans et al, 1993). However, they were not statistically significant and there
were no trends for duration of employment or latency. Also, there was no increase
in risk for workers in the chemical industry.
The American Cancer Society enrolled 1.2 million randomly selected people in a
study of life style and environmental factors in relation to cancer mortality, 2780 of
whom had a history of or developed melanoma during the 6-year study follow-up
period (Pion et al, 1995). These cases were compared with controls selected from
the remaining people enrolled on a 1:3 basis and matched for age, sex, race, and
geographic location. In men, the risk of melanoma was elevated in high-paying
versus low-paying jobs (OR = 1.58; p <0.001) and in white-collar versus blue-
collar jobs (OR = 1.33; p <0.001), but unrelated to outdoor versus indoor
occupations. In women, the findings were inconclusive. The only specific work-
related risk factor was exposure to x-rays. Other large community-based studies in
Australia, Britain and Sweden came to similar results (Burnley, 1997; Vågerö et al,
1990).

Other cancers

Gérin et al. (1998) conducted a community-based case-control study of 19 specific
cancers excluding leukaemia in 3730 men and 533 controls aged 35-70 years and
resident in Montreal, Canada. Their exposure to various workplace chemicals
including benzene, toluene, xylenes and styrene was estimated through interviews
and from workplace records. There were 737 subjects, mainly mechanics, service
station attendants and shoe workers, who had been exposed to benzene, usually
with concomitant exposure to toluene and xylenes. However, there was no evidence
that the risks of common cancers such as those of the gastrointestinal tract, lungs,
prostate, bladder or kidney were related to exposure to any of the chemicals under
investigation. For NHL (215 cases) and melanoma (103 cases), the ORs for
benzene exposure were <1.00.
The industry-based study by Wong et al. (1999) mentioned above under cancer of
the blood and lymphatic system also included 12 cases of kidney cancer. There was
no difference between cases and controls with regard to duration of exposure or to
cumulative or peak exposures to hydrocarbons.
Petralia et al. (1999) studied the relationship between the risk of pre-menopausal
breast cancer and exposure to benzene or polycyclic aromatic hydrocarbons in 301
cases and 316 controls sampled from two counties in New York State between
1986-91. There were 55 breast cancer cases and 35 controls who had been exposed
to benzene, mainly through employment as laboratory technicians, painters,
sculptors, craft-artists, or assemblers in the motor vehicle industry. Following
adjustment for age, years of education, age at first birth, age at menarche, history of
benign breast disease, history of breast cancer in a first-degree relative, body mass
index, and months of lactation, four variables relating to benzene had ORs that
reached or approached statistical significance. These were duration of exposure 4
years (2.57 (1.23-4.73)); medium-to-high probability of exposure (1.95 (1.14-
3.33)); low average exposure intensity (2.36 (1.30-4.30)); and medium-to-high
cumulative exposure (1.93 (1.00-3.72)).
In Denmark, Hansen (2000) conducted a nationwide register-based case-control
study on primary breast cancer in men, which included 230 cases and 12,880
                                                         Priority Existing Chemical Number 21
                                     100

          controls. Allowing for a lag time 10 years and after adjustment for socio-
          economic status, the OR was 2.5 (1.3-4.5) in all men with >3 months of
          employment as car mechanic or petrol station worker and 5.4 (2.4-11.9) in men
          who were <40 years old when first employed in those occupations. Exposure to
          benzene was not assessed.

          Conclusions

          While the case-control studies reviewed above have limitations in statistical power
          and study quality, there are several which indicate that occupation and/or benzene
          exposure is associated with an increased risk of cancer of the blood and lymphatic
          system, including, but not limited to AML and other leukaemias. Positively
          identified risk factors include employment in upstream petroleum production, at
          petroleum terminals, on deck on chemical or petroleum product tankers, and as a
          mechanic, machinist, chemical worker, chemist, painter, driver or logger. The
          studies by Health Watch (1998) and Richardson (1992) found that the risk was
          significantly elevated at relatively high, but not at lower levels of exposure to
          benzene.
          There are some indications that parental exposure to benzene and in particular
          maternal exposure during pregnancy may be linked to childhood leukaemia, but the
          overall evidence for this association is limited at present. Other tentative findings
          suggest a relationship between the risk of breast cancer and exposure of female
          workers to benzene on the one hand and between male breast cancer and exposure
          to petrol and vehicle exhaust on the other.

11.6.3 Ecological studies

          Leukaemia and car traffic variables

          Robinson (1982, 1991) found a strong relationship between leukaemia mortality
          and vehicle usage (as monitored by the annual rate of vehicle fatalities) in
          Australia, France, Germany, Italy, Japan, The Netherlands, UK and USA. In a
          study of all incident childhood cancer in Denver, Colerado, USA, between 1976-
          83, Savitz & Feingold (1989) found a statistically significant association between
          traffic density at the place of residence at the time of diagnosis and the risk for all
          leukaemia combined. In a sample of 22 British counties, Wolff (1992) found a
          significant correlation coefficient between the incidence of AML, lymphoma, ALL,
          CLL and low-grade NHL for the years 1984-88 and the number of cars per
          household reported in the 1981 Great Britain Population Census.
          Swaen & Slangen (1995) found a non-significant, inverse relationship between
          leukaemia mortality and petrol consumption in 19 European countries, but a weak
          positive association between the incidence of myeloid leukaemia and the
          consumption of petrol per km2. However, both findings could be due to unrelated
          factors such as changes in prognosis or country differences in leukaemia case
          ascertainment. As such, the authors concluded that their study did not support an
          association between petrol consumption and leukaemia incidence or mortality.
          Nordlinder & Järvholm (1997) compared the 1975 car density in Swedish local
          government areas with the 1975-1985 cumulative incidence of ALL, AML, CML
          and NHL in persons under 25. None of these showed a significant correlation with
          car density, although the combined group of areas with >5 cars/km2 had a higher
          rate of AML than those with <5 cars/km2 (95% CI for the difference: 0.1-4.0
          cases/106 person-years).
Benzene                                        101

       Leukaemia and industry emission variables

       There was an excess mortality rate between 1950-69 from childhood leukaemia and
       young adult Hodgkin's disease and lymphoma among residents in the heavily
       industrialised New Jersey-New York-Philadelphia Metropolitan Region compared
       to USA as a whole (Greenberg et al, 1980). However, other early studies of
       populations residing in the vicinity of petroleum refineries and chemical plants
       have not suggested links with cancers of the blood and lymphatic system (Blot et
       al, 1977; Hearey et al, 1980; Hoover et al, 1975; Kaldor et al, 1984).
       A more recent study of an area within a radius of 3.0 km of a large petrochemical
       plant in South Wales, UK, compared the 1974-91 incidence of leukaemia and
       lymphoma with onset before age 25 among study area residents with those in the
       regional population (Lyons et al, 1995). There were no statistically significant
       differences, although the number of observed cases was higher than expected for all
       disease types except myeloid leukaemia. Data from ambient monitoring for
       benzene around the site showed monthly peak values varying from 4-16 ppb.

11.7   The Illawarra leukaemia cluster
       The Illawarra leukaemia cluster refers to a group of 12 cases of leukaemia that
       occurred in 1989-96 in three contiguous suburbs bordering the Port Kembla
       steelworks near Wollongong, New South Wales (Westley-Wise et al, 1999). There
       were 3 cases of AML, 3 of CML and 6 of ALL. All cases were under 44 years of
       age at the time of diagnosis and nine were 20 years of age. Four attended the same
       local high school in the late 1980s, three of them in the same school year. Using the
       rest of the region as reference population, only 3.49 cases were expected,
       corresponding to a SIR of 3.44 (1.42-6.92).
       The regional health authority launched an investigation which examined a wide
       range of possible explanations for the cluster, including benzene emissions from
       the coking ovens and coal gas by-product plant at the steelworks. It was estimated
       that ambient air levels of benzene had averaged up to 3 ppb since 1970, although
       the mean levels measured in 1996 did not exceed 1 ppb within 1.6 km from the
       plant. As this is less than one-thousandth of the level at which leukaemia risk has
       been identified in occupational epidemiological studies, the authors concluded that
       the cause of the cluster was uncertain, although an association with chemical
       exposures could not be totally excluded. The odds that it was due to chance were
       calculated at 1 in 4-8000 (Westley-Wise & Hogan, 1997).

11.8   Summary and conclusions
       There is anecdotal evidence that acute exposure to benzene vapours causes
       dizziness and other CNS effects at concentrations above 25 ppm and eye, mucous
       membrane and skin irritation at levels above 30-60 ppm. Furthermore, aspiration of
       liquid benzene has been observed to cause lung oedema and bleeding. Deaths from
       cardio-respiratory arrest have occurred following short-term inhalation of 20,000
       ppm benzene, or from ingestion of a single dose of 125 mg benzene per kg BW.
       Several studies demonstrate that repeated exposure to benzene may induce bone
       marrow depression, cause damage to genetic material and induce leukaemia,
       specifically AML. Some studies also point to an association between benzene
       exposure and the risk for lymphoma, specifically NHL and MM. For bone marrow
       depression, the best estimate for a LOAEL is 7.6 ppm (TWA8), based on current

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                                           102

          data. An appropriate NOAEL has not been determined, although studies with
          various limitations indicate that it is likely to be >0.5 ppm (TWA8). Dose-related
          structural or numerical chromosome aberrations have been detected in peripheral
          LC of workers exposed to benzene levels above 10 ppm (TWA8), but a threshold
          level has not been identified. The risk of developing leukaemia increases with
          exposure and has been shown to be significantly elevated above, but not below, a
          cumulative exposure of 50 ppm-years, corresponding to an average occupational
          exposure of 1.25 ppm (TWA8) over 40 years. However, this finding derives from a
          single cohort study with insufficient statistical power to rule out the possibility of
          some increase in leukaemia risk at lower exposures.
          In addition, some studies suggest an association between repeated exposure to
          benzene or benzene-containing products and several other adverse health effects,
          including menstruation disorders, spontaneous abortions, melanoma and breast
          cancer in adults and reduced birth weight and leukaemia in the children of exposed
          parents. However, considering the multiple exposure circumstances in most studies
          and the limited consistency of the findings reviewed above, the human database
          does not in itself suffice to establish a causal relationship between these effects and
          benzene exposure.




Benzene                                        103

       12. Modes of Action

       While a general overview of benzene metabolism has been presented in Section 9,
       this section presents a review of the evidence for the molecular basis of the action
       of benzene metabolites. Several reviews of benzene metabolism and the proposed
       mechanisms of toxicity have been published (Ross, 1996; Snyder, 2000; Snyder et
       al, 1993; Snyder & Hedli, 1996; Yardley-Jones et al, 1991).
       Exposure to benzene can result in haematotoxicity, immunotoxicity and
       carcinogenicity in humans and animals. Haematotoxicity resulting from chronic
       benzene exposure can present as anaemia, aplastic anaemia, leukopenia,
       lymphocytopenia, thrombocytopenia, or pancytopenia (Aksoy, 1989). The principal
       carcinogenic response in humans to chronic benzene exposure is leukaemia while
       other animals tend to produce solid tumours in specific organs. While the liver is
       the initial site for the biotransformation of benzene, hepatotoxicity is not a
       consequence of benzene exposure. However, a number of studies have shown that
       for benzene to produce haematotoxicity in animals it must first be metabolised by
       the liver (Andrews et al, 1977; Sammett et al, 1979). Subsequent accumulation of
       the major hepatic metabolites, phenol, hydroquinone and catechol, occurs in the
       bone marrow where they are known to persist for varying durations after exposure
       to benzene ceases (Rickert et al, 1979). Longacre et al. (1981) observed that strains
       of mice that exhibit greater sensitivity towards benzene accumulate more benzene
       metabolites (water-soluble and covalently bound) in bone marrow compared to less
       sensitive strains. However, administration of specific benzene metabolites to test
       animals has failed to reproduce the characteristic toxicity of benzene although co-
       administration of phenol and hydroquinone has been shown to mimic its
       haematotoxic effects (Eastmond et al, 1987). These data suggest that phenolic
       metabolites of benzene in combination and not the parent molecule are responsible
       for the haematotoxicity of benzene. The data further suggest that subsequent
       biotransformation of the hepatic metabolites to reactive intermediates is required
       and that this occurs within the bone marrow and those animal organs exhibiting
       solid tumours.

12.1   Activation of benzene metabolites
       In order for the phenolic metabolites of benzene to exert their toxic effect on bone
       marrow, they must undergo activation to their oxidised forms. Once activated, they
       can participate in covalent binding reactions with macromolecules. Several studies
       have identified the presence of peroxidase enzymes in bone marrow and other
       tissues as the primary mechanism by which activation of benzene phenolic
       metabolites is achieved (Eastmond et al, 1986; Lévay et al, 1993). The peroxidases
       are a diverse class of enzymes that catalyse the general reaction:
                            Donor + H2O2  oxidised donor + 2H2O.
       While peroxidases generally act to detoxify peroxides, including hydrogen
       peroxide, that form within cells as a result of several metabolic reactions, a number
       of specialised peroxidases with other functions have evolved. In particular, the
       leukocytes of several species, including humans, have been shown to possess large
       amounts of a specific form, myeloperoxidase (Bainton et al, 1971; Himmelhoch et
       al, 1969). In concert with the leukocyte nicotinamide adenine dinucleotide

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                                           104

          phosphate (NADPH) oxidase system that causes hydrogen peroxide to be produced
          (Patriarca et al, 1971), myeloperoxidase plays a crucial role in the host defence
          system by producing a potent microbicidal oxidant that protects the host from
          microorganisms. Immature leukocytes in the bone marrow generally have higher
          levels of myeloperoxidase than circulating mature cells (Bainton et al, 1971).
          Consequently, bone marrow has considerable capacity to metabolise suitable
          electron donors including the benzene metabolites, phenol, hydroquinone, catechol
          and 1,2,4-trihydroxybenzene, to reactive species.

12.1.1 Activation of phenol
          Incubation of phenol with human leukocyte lysates, which contain
          myeloperoxidase, have demonstrated the formation of reactive intermediates that
          covalently bind to macromolecules in the presence of hydrogen peroxide as a co-
          oxidant (Eastmond et al, 1986; Smith et al, 1989). Eastmond et al. (1986)
          concluded that although 4,4'-biphenol and diphenoquinone were identifiable
          reaction products derived from the oxidation of phenol, only 6% of the covalent
          binding could be attributed to diphenoquinone with most of the covalent binding
          observed due to other reactive species, possibly the phenoxy radical or oxidation
          products of 2,2'-biphenol or 4,4'-biphenol. However, in the presence of
          hydroquinone, phenol appears to undergo a recycling process such that the initial
          phenoxy radical is reduced to phenol by transferring an electron to hydroquinone
          (Smith et al, 1989), thus limiting the formation of biphenol derivatives.

12.1.2 Activation of hydroquinone and catechol
          Under physiological conditions, hydroquinone, catechol and 1,2,4-
          trihydroxybenzene can undergo autoxidation to their respective semiquinone and
          quinone forms (Brunmark & Cadenas, 1989) or their oxidation can be facilitated by
          the presence of a peroxidase and hydrogen peroxide (Sadler et al, 1988; Schlosser
          et al, 1989; Smith et al, 1989). Quinones are chemically reactive species capable of
          depleting intracellular glutathione, promoting lipid peroxidation and forming
          covalent adducts with macromolecules (Bolton et al, 2000; Irons, 1985; Monks et
          al, 1992). Several studies have shown that hydroquinone and catechol are readily
          oxidised by human myeloperoxidase (Eastmond et al, 1986; Sadler, et al, 1988) and
          it has been observed that the oxidation of hydroquinone to benzoquinone by
          peroxidase enzymes is enhanced by the presence of excess phenol which acts as a
          co-oxidant obviating the need for hydrogen peroxide to drive the reaction (Smith et
          al, 1989; Subrahmanyam, et al, 1990). Hydroquinone was found to be metabolised
          by activated human neutrophils to covalent-binding species and the amount of
          binding could be increased by approximately 70% by the addition of phenol
          (Eastmond et al, 1987). Subrahmanyam et al. (1990) reported that the presence of
          phenol enhanced the covalent binding of [3H]-hydroquinone metabolites to
          macromolecules of mouse blood and bone marrow, but not to the kidneys or liver.
          It was further noted that hydroquinone enhanced binding of [3H]-phenol
          metabolites in blood, bone marrow and the kidneys but inhibited binding in the
          liver. In contrast, catechol did not enhance [3H]-hydroquinone metabolite binding.
          Sadler et al. (1988) observed that the oxidation of catechol by human neutrophil
          peroxidases (myeloperoxidase) resulted in the formation of 1,2-benzosemiquinone
          and 1,2-benzoquinone. Bhat et al. (1988) found that the addition of [14C]-catechol
          to rat or human bone marrow cells resulted in the formation of a glutathione-
          conjugate and covalent binding of radiolabel to protein. Both conjugate formation
          and the binding of radiolabel were substantially increased by the presence of
Benzene                                       105

       hydrogen peroxide or phenol, however, protein binding could be markedly
       decreased by the presence of exogenous glutathione (GSH) or hydroquinone.

12.1.3 Role of cyclooxygenase
       In addition to activation by peroxidases, phenol and hydroquinones can be
       activated by prostaglandin H synthase (cyclooxygenase), an enzyme with
       oxygenase and endoperoxidase activity (Markey et al, 1987; Schlosser et al, 1989).
       Acting as an endoperoxidase, the enzyme requires an oxidant as a co-substrate
       which phenol or hydroquinones can replace (Markey et al, 1987). Prostaglandin H
       synthase is present in a number of bone marrow-derived cells including
       monocyte/macrophage populations and platelets and converts arachidonic acid to
       several prostaglandins including prostaglandin E2 (PGE2). PGE2 plays a major role
       in the inhibition of progenitor cell proliferation and differentiation (Gentile and
       Pelus, 1987). In vitro, both phenol and hydroquinone are activated by cell lysates
       containing prostaglandin H synthase or by the purified enzyme and in the presence
       of arachidonic acid or hydrogen peroxide (Schlosser et al, 1989).
       The role of prostaglandin H synthase activity has been demonstrated in a number of
       mouse strains (B6C3F1, DBA/2 and C57BL/6) where it was shown that bone
       marrow toxicity could be reduced by prior treatment of the animals with non-
       steroidal anti-inflammatory drugs (aspirin, indomethacin or meclofenamate) that
       inhibit prostaglandin H synthase activity (Gaido and Wierda, 1987; Kalf et al,
       1989). Pirozzi et al. (1989) further demonstrated that benzene-induced bone
       marrow depression and micronucleus formation in erythrocytes of C57B1/6 mice
       could be prevented by the co-administration of indomethacin and that protection
       was achieved at doses that did not inhibit cytochrome P450 or myeloperoxidase
       activity.
       The bio-activation of catechol by prostaglandin H synthase activity in rat bone
       marrow appears to be limited as the addition of arachidonic acid provided only a
       small but significant (p<0.05) increase in covalent binding which was of limited
       duration (Bhat et al, 1988).

12.1.4 Formation of reactive oxygen species
       In addition to the formation of semiquinone and quinone species, the oxidation of
       hydroquinones results in the formation of reactive oxygen species. Initially,
       molecular oxygen is reduced to superoxide anion which, by dismutation, is
       converted to hydrogen peroxide (Figure 12.1). In the presence of transition metal
       ions (for example, iron) the very reactive hydroxyl radical can form. These reactive
       species can promote the oxidation of protein and DNA bases, induction of
       chromosomal aberrations, lipid peroxidation and the modulation of cellular
       functions.
       While hydroquinone and its semiquinone radical can both reduce molecular oxygen
       to superoxide, Sadler et al. (1988) found superoxide production by catechol to be
       limited to the first one electron reduction step to 1,2-benzosemiquinone with
       molecular oxygen being unable to effect the subsequent oxidation of the
       semiquinone to the quinone form. In contrast, 1,2,4-benzenetriol undergoes rapid
       autoxidation to yield hydrogen peroxide (Brunmark & Cadenas, 1988).




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          Figure 12.1. Redox cycle of hydroquinone with formation of reactive oxygen
          species and biological effects

                                                         NQO1




                                                                          NADPH-Cytochrome
                               NADPH-Cytochrome
                                                                             reductase
                                   reductase or
                                Disproportionation
                                                             .
                         OH                              O                                     O
                                                                           Autoxidation
                                   Autoxidation
                                                                           /Peroxidase
                                   /Peroxidase



          Hydroquinone                                                                               1,4-Benzoquinone
                                                                                        .-
                                                  .-
                         OH                              OH                                    O
                                                                    O2                O
                                                O
                              O2                                                          2
                                                     2



                                  Dismutation/
                                                                                          DNA adducts
                              Superoxide dismutase               H2O2

                                                                                          DNA oxidation
                                                               3+
                                                         Fe
                                                                                          Protein oxidation
                                                                                          Lipid peroxidation
                                                                      .
                                                                                          Modulation of cellular function
                                                                 OH

          The detoxification of quinones can be achieved by a two-electron reduction to their
          fully reduced forms. Two enzymes involved in the reduction of quinones are
          NADPH-cytochrome reductase and NAD(P)H:quinone oxidoreductase (NQO1;
          DT-diaphorase; Lind et al, 1982). In the case of NADPH-cytochrome reductase,
          reduction of the quinone to a semiquinone is achieved by a one-electron transfer to
          give a semiquinone and a second electron is transferred to molecular oxygen to
          yield the superoxide anion. The resulting semiquinone is then free to autoxidise to
          the quinone producing more superoxide. However, it has been proposed that redox
          cycling of the semiquinone could not be maintained by NADPH-cytochrome
          reductase at physiological pH due to protonation of the semiquinone thus
          minimising superoxide production (Boersma et al, 1994). In the case of NQO1,
          reduction to the hydroquinone is achieved by a simultaneous two-electron transfer
          to the quinone with no reduction of molecular oxygen. The redox cycle for
          hydroquinone, the role of NADPH-cytochrome reductase and NQO1 and the
          biological effects of these processes are illustrated in Figure 12.1.
          In cells that possess both peroxidase and NQO1 activities, the ratio of the two
          enzymes may determine the extent to which reactive metabolites form. Thus a high
          intracellular myeloperoxidase/NQO1 ratio, such as occurs in human stroma and
          CD34+ bone marrow progenitor cells, may result in a greater risk of benzene-
          induced cellular toxicity (Ross et al, 1996b). Although characterisation of NQO1
          activity in primary cultures of mouse bone marrow stromal cells was found to be
          low, the enzyme was shown to be inducible and induction of the enzyme conferred
          protection against hydroquinone-induced toxicity (Twerdok et al, 1992).
          Conjugation reactions, for example with GSH, can enhance the ability of
          hydroquinones to autoxidise. Glutathionyl hydroquinone, identified as a urinary
          benzene metabolite (Nerland & Pierce, 1990), was found by Brunmark & Cadenas
          (1988) to autoxidise at a rate 8-fold faster than hydroquinone. Rao (1996)


Benzene                                                  107

       concluded that, in vitro, glutathionyl hydroquinone acted as a potent pro-oxidant
       based on its ability to degrade DNA.
       Reactive oxygen species may also form due to the reduction of molecular oxygen
       by the action of cytochromes P450. Johannson & Ingelman-Sundberg (1983)
       observed that benzene could be directly oxidized to phenol by hydroxyl radicals
       derived from the reduction of molecular oxygen by microsomal cytochrome P450
       activity or reconstituted enzyme systems. Similarly, Kahn et al. (1990) detected the
       presence of hydroxyl radicals during the NADPH-dependent metabolism of
       benzene by rat bone marrow microsomal preparations.

12.2   Reactivity of benzene metabolites
       Results derived from in vivo and in vitro studies indicate that a number of
       mechanisms contribute to the cytotoxicity, genotoxicity and carcinogenicity of
       benzene metabolites. Cytotoxicity can arise due to depletion of intracellular GSH
       and changes in intracellular redox status (Ludewig et al, 1989; Rao & Snyder,
       1995; Witz, 1985) and covalent binding of benzene metabolites to macromolecules
       (Latriano et al, 1989; Lutz and Schlatter, 1977; Mazzullo et al, 1989; Snyder et al,
       1987). Metabolites suspected of contributing to the genotoxicity and
       carcinogenicity of benzene include benzene oxide, hydroquinone, catechol, 1,2,4-
       trihydroxybenzene and trans,trans-muconaldehyde. The effects induced by these
       metabolites comprise DNA base alterations, chromosome structural aberrations and
       aneuploidy. However, the metabolite concentrations at which many of these effects
       have been shown to occur in vitro are higher than those expected to occur in vivo.

12.2.1 Genotoxicity
       Several studies have demonstrated the formation of DNA adducts after incubation
       of benzene metabolites with purified DNA. Hydroquinone when incubated with
       calf thymus DNA resulted in the formation of deoxycytidine (Pongracz et al, 1990),
       deoxyadenosine (Pongracz & Bodell, 1991) and deoxyguanosine adducts (Jowa et
       al, 1990). Gut et al. (1996) were able to demonstrate the formation of the N-7
       guanine adduct on exposure of calf thymus DNA to benzene oxide under in vitro
       conditions while Latriano et al. (1989) found trans,trans-muconaldehyde to form
       adducts with deoxyguanosine. In addition to nuclear DNA, in vitro studies have
       shown mitochondrial DNA, derived from bone marrow mitoplasts, to undergo
       alkylation by benzene metabolites (Kalf et al, 1985; Snyder et al, 1987).
       Under cellular conditions, a comparison of the ability of benzene metabolites to
       induce DNA adduct formation in HL-60 cells, a promyelocytic leukemia cell line,
       found hydroquinone to be 7-9 times more effective at inducing such adducts than
       catechol or 1,2,4-trihydroxybenzene and that a correlation existed between adduct
       formation and cytotoxicity. Co-incubation of hydroquinone with either catechol or
       1,2,4-trihydroxybenzene produced a synergistic effect that was 3-6 times greater
       than the added effects of each metabolite. It was further observed that DNA
       adducts form in the presence of benzene metabolite mixtures which are not
       observed when cells are incubated with the individual metabolites, leading the
       authors to suggest that other processes leading to adduct formation may be
       involved (Lévay & Bodell, 1992; Lévay et al, 1991). Chenna et al. (1995)
       subsequently identified an enzyme with glycosylase activity that excises
       deoxycytidine and deoxyadenosine adducts of benzoquinone from DNA.



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          It is noteworthy that transfected HL-60 cells expressing a high level of NQO1
          activity exhibited lower levels of DNA adduct formation when exposed to
          hydroquinone compared to non-transfected HL60 cells which are deficient in
          NQO1 activity. Similarly, C15 cells, a myeloperoxidase-deficient HL-60 subline,
          produced lower levels of DNA adducts with hydroquinone compared to HL-60
          cells which normally express high levels of myeloperoxidase (Wiemels et al, 1999).
          The ability of hydroquinone species to induce mutations has been demonstrated by
          Joseph et al. (1998). In a series of in vitro experiments, it was demonstrated that
          sequence-specific frame shift mutations could be caused by hydroquinone, but not
          semiquinone, benzoquinone or reactive oxygen species, in the supF tRNA gene. It
          was further demonstrated that BALBc/3T3 cells undergo transformation by
          hydroquinone (15 µM) and that the frequency of transformation could be increased
          by a tumour promoter. Such initiated cells produced tumours with 100% frequency
          when injected into severe combined immunodeficient (SCID) mice. Sakai et al.
          (1995) previously had shown that benzoquinone caused initiation in a two-stage
          model of carcinogenesis using BALB/3T3 cells.
          Mueller et al. (1987) detected the alkylation product of benzene oxide, N-7-
          phenylguanine, in the urine of rats exposed to benzene (500 ppm) for 8 h while
          Norpoth et al. (1996) detected several benzene-derived urinary guanine adducts
          following the administration of benzene to rats. However, it should be noted that
          the presence of N-7-phenylguanine in the urine does not provide sufficient
          evidence that the adduct is derived from DNA excision-repair activities. The
          presence of benzene-induced DNA adducts has been detected in the tissues of rats
          dosed with [14C]-benzene (Lutz and Schlatter, 1977; Mazzullo et al, 1989) although
          the nature of the adducts was not investigated. However, Reddy et al. (1989b)
          found only equivocal evidence for the in vivo formation of aromatic DNA adducts
          in the bone marrow, liver, kidney and mammary gland of benzene-treated female
          Sprague-Dawley rats. DNA isolated from Zymbal glands was found to contain 4
          adducts per 109 DNA nucleotides, although the adducts did not correspond to major
          adducts described in in vitro studies. Thus it was concluded that DNA-quinone
          adduct formation in the rat is not extensive, possibly due to the efficient elimination
          of quinones by other mechanisms. In addition to forming DNA adducts in the bone
          marrow of experimental animals, benzene exposure produced DNA adducts in the
          livers of male mice (Lutz and Schlatter, 1977); however, liver tumours were not
          observed in 2-year carcinogenicity studies of these animals (NTP, 1986).
          The mutation frequency of V75 Chinese hamster cells increased in a dose-
          dependent manner after treatment for 1 h with benzoquinone, an effect that was
          found to be independent of intracellular GSH status and observed at low (< 10 µM)
          concentrations. The frequency of micronucleated cells was also increased by
          benzoquinone but only at concentrations greater than 20 µM. In contrast,
          benzoquinone did not induce sister chromatid exchanges at any concentration up to
          100 µM (Ludewig et al, 1989).
          As described in Sections 10.6 and 11.5, several studies have demonstrated
          chromosomal aberrations in experimental animals and humans following exposure
          to benzene. While the administration of benzene to CD-1 mice resulted in
          micronuclei formation, treatment with either phenol, hydroquinone or catechol
          failed to induce micronuclei (Gad-el-Karim et al, 1985). Barale et al. (1990)
          demonstrated, in vivo, a synergistic effect on micronuclei formation in CD-1 mice
          bone marrow cells by the concurrent administration of hydroquinone and phenol.


Benzene                                        109

       Lewis et al. (1988) reported that hydroquinone, under in vitro conditions, caused
       DNA to form single- and double-strand breaks by a mechanism that was
       independent of reactive oxygen species. In contrast, catechol did not induce DNA
       damage. These investigators further observed that DNA could be degraded by
       1,2,4-trihydroxybenzene, an effect inhibited by scavengers of reactive oxygen
       species. When tested together in vitro, hydroquinone and catechol produced a
       synergistic effect on micronuclei formation in human lymphocytes, possibly by
       interfering with mitotic spindle function and disturbing chromosome segregation
       (Robertson et al, 1991). Benzoquinone has also been reported to interfere with
       microtubule assembly by blocking a thiol-sensitive binding site (Irons et al, 1981).

12.2.2 Oxidative stress
       The formation of reactive oxygen species is a normal part of cellular biochemistry
       and is considered to be an important component of intracellular signalling
       processes, including mediating signal transduction within haematopoietic cells
       initiated by growth factor signals (Sattler et al, 1999). However, exposure of
       biological systems to excessive levels of reactive oxygen species results in the
       induction of oxidative stress. Oxidative stress can induce oxidative modification of
       DNA bases and chromosomal abnormalities, depletion of intracellular GSH,
       changes in intracellular redox status, peroxidation of lipids, oxidation of proteins
       and modulation of cellular functions. The role of oxidative stress in benzene-
       mediated toxicity has been extensively reviewed by Subrahmanyam et al. (1991).
       Rao & Snyder (1995) examined the effects of hydroquinone, benzoquinone and
       1,2,4-trihydroxybenzene (50 µM) on several parameters of antioxidant defence
       function of HL-60 cells. The three metabolites did not induce the cells to generate
       superoxide anion or nitric oxide but did produce detectable levels of hydrogen
       peroxide. Intracellular GSH levels were depleted by hydroquinone and 1,2,4-
       trihydroxybenzene but not benzoquinone.
       The presence of lipid peroxidation products was found to increase in rat tissues
       following the administration of benzene (Khan et al, 1984) while urinary levels of
       malondialdehyde, a biomarker of lipid peroxidation, were elevated in rats receiving
       hydroquinone (Ekström et al, 1988). The presence of intracellular peroxidation
       products has been detected in HL60 cells following treatment with either 1 µM
       benzoquinone or 10 µM hydroquinone (Hiraku & Kawanishi, 1996). Several
       studies have identified the presence of 8-hydroxydeoxyguanosine (8-OHdG) as a
       sensitive biomarker of DNA damage due to oxidative stress (Kasai & Nishimura,
       1984, 1986; Shigenaga et al, 1989). In two occupational studies in workers known
       to have benzene exposure, a dose-response relationship was demonstrated between
       the exposure level and urinary 8-OHdG levels (Lagorio et al, 1994b, Nilsson et al,
       1996). However, the presence of 8-OHdG in the urine is not conclusive evidence of
       DNA excision-repair activities in response to oxidative modification of DNA.
       Benzoquinone species and trans,trans-muconaldehyde readily react with GSH
       (Brunmark & Cadenas, 1988; Rao et al, 1982) which can lead to depletion of
       intracellular GSH levels and changes in intracellular redox status. Treatment of
       V79 Chinese hamster cells with benzoquinone for 1 h resulted in decreased GSH,
       NADPH and nicotinamide adenine dinucleotide levels but only at cytotoxic
       concentrations at or above 100 µM (Ludewig et al, 1989). Ekström et al. (1988)
       found rat hepatic GSH levels to be depleted after administration of hydroquinone
       by gavage while the administration of trans,trans-muconaldehyde to mice for 10 or
       16 days resulted in decreased hepatic sulfhydryl levels (Witz et al, 1985).

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          The growth of HL-60 cells was found to be stimulated by the presence of
          hydroquinone within the range of 10-40 µM. Similarly, the incorporation of [3H]-
          thymidine was enhanced by hydroquinone, benzoquinone or 1,2,4-benzenetriol.
          However, the effects produced by the three metabolites could be eliminated if the
          cells were pre-incubated with catalase, an antioxidant specific for hydrogen
          peroxide. The effects of hydroquinone and benzoquinone could be mimicked by
          reactive oxygen species produced by a xanthine/xanthine oxidase system. It was
          further observed that while hydroquinone or benzoquinone did not reduce the cell
          cycle time they did increase the number of cells entering into S-phase from G0/G1
          phase (Wiemels & Smith, 1999). The role of reactive oxygen species, and in
          particular hydrogen peroxide, has been further explored by Sattler et al. (1999).
          These investigators found haemopoietic growth factors to induce increased levels
          of reactive oxygen species in MO7e cells, a growth factor-dependent human
          megakaryocytic cell line. Treatment of these cells with either growth factors or
          hydrogen peroxide resulted in increased tyrosine phosphorylation of cellular
          proteins, a key step in intracellular signalling processes.

12.2.3 Modulation of cellular function
          The mature macrophage produces interleukin-1 (IL-1), a cytokine essential for stem
          cell maturation. However, it has been observed that macrophages treated with
          hydroquinone (10 µM) produce less IL-1 than control cells (Thomas et al, 1989).
          This is due to the inhibition of calpain, a protease required for the conversion of
          pre-IL-1 to its active form, by hydroquinone (Renz & Kalf, 1991; Kalf et al, 1996).
          Treatment of isolated mouse bone marrow-derived macrophages with non-
          cytotoxic doses of hydroquinone (10 µM) resulted in a 10 to 30% reduction in total
          calpain activity (Miller et al, 1994). In contrast, the production of PGE2 by bone
          marrow cells, in vivo, was enhanced by benzene exposure (Gaido & Wierda, 1987;
          Kalf et al, 1989) although it is uncertain how the release of arachidonic acid, the
          precursor of prostaglandins, from phospholipid stores is initiated under these
          conditions. However, hydroquinone and catechol have been shown to regulate
          protein kinase C (PKC) activity by producing a short term cytosol-to-membrane
          translocation of PKC (Gopalakrishna et al, 1994), a key step in the mobilisation of
          arachidonic acid. Da Silva et al. (1989) have further shown that benzene can
          directly activate PKC. PGE2 has been identified as an inhibitor of
          granulocyte/macrophage progenitor cell proliferation (Gentile & Pelus, 1987).
          The growth of granulocyte/macrophage colonies was stimulated in a synergistic
          manner by co-treatment of mouse bone marrow cells with low concentrations of
          hydroquinone (10-8 to 10-5 M) and recombinant granulocyte/macrophage colony
          stimulating factor (GM-CSF) compared to cells treated with GM-CSF alone. The
          maximal response was achieved with 1 µM hydroquinone but no effect was
          observed when phenol, catechol or trans,trans-muconaldehyde were substituted for
          hydroquinone (Irons et al, 1992). While treatment of HL-60 cells with
          hydroquinone at concentrations between 10-40 µM resulted in an increase in cell
          proliferation, at a concentration greater than 50 µM hydroquinone caused a
          decrease in cell viability (Wiemels & Smith, 1999). In a further study, Wiemels et
          al. (1999) demonstrated that 12 h after treatment with hydroquinone (50 µM)
          approximately 40% of HL-60 cells were apoptotic as determined by the terminal
          deoxynucleotidyl-transferase (TdT) assay. Apoptosis is a form of physiological cell
          death characterised by altered cell morphology including condensation of the
          cytoplasmic and nuclear compartments and internucleosomal DNA fragmentation.
          Apoptosis has been observed to occur in a dose-dependent manner when HL-60

Benzene                                      111

       cells are treated with hydroquinone and catechol (25 to 100 µM) but not by phenol.
       Similarly, hydroquinone or catechol induces CD34+ human bone marrow
       progenitor cells to undergo apoptosis (Moran et al, 1996). These reports support an
       earlier study in which weak internucleosomal cleavage was observed in HL-60
       cells following incubation for 4 h with 20 µM hydroquinone and 5 µM
       benzoquinone and pronounced cleavage observed at 50 µM hydroquinone and 10
       µM benzoquinone using pulse-field gel electrophoresis (Hiraku and Kawanishi,
       1996).

12.3   Critical biological effects

12.3.1 Bone marrow toxicity

       The critical biological effect of benzene in all experimental species is bone marrow
       toxicity characterised by a reduction in bone marrow cellularity. Bone marrow
       consists of stromal cells (composed of macrophage and fibroblastoid cell
       populations) along with stem and progenitor cell populations that form a complex
       matrix within which are produced a number of essential regulatory growth factors.
       Stromal cells regulate stem and progenitor cell proliferation, differentiation and
       maturation by producing both inducers (colony stimulating factors (CSFs) and
       interleukins, particularly IL-1) and inhibitors (PGE2) of cell growth. PGE2 inhibits
       cell growth by suppressing the production of CSFs and IL-1. Benzene metabolites
       appear to disrupt the balance of these regulatory factors by inhibiting production of
       CSFs and IL-1 and increasing PGE2 production, although low levels of
       hydroquinone can replace or augment, in vitro, the effects of growth factors
       (Wiemels & Smith, 1999). Evidence to support this hypothesis has been provided
       by experiments in which the co-administration of IL-1 abrogates the effects of
       benzene treatment. Similarly, if non-steroidal anti-inflammatory agents, which
       inhibit PGE2 production and the cyclooxygenase-dependent oxidation of phenol
       and hydroquinone, are co-administered with benzene, haematotoxicity is not
       observed. Although increased apoptosis has been observed by exposing bone
       marrow cells to various benzene metabolites, these effects appear to occur only at
       high metabolite concentrations.

12.3.2 Leukaemia
       Leukaemia is the progressive proliferation of abnormal and usually monoclonal
       leukocytes in hemopoietic tissues. Benzene-induced leukaemias are typically
       myelogenous in nature rather than lymphocytic. Currently, the mechanism(s) by
       which benzene induces leukaemia in susceptible individuals remains obscure.
       Clinical studies of therapy-related myelodysplastic syndromes and acute myeloid
       leukaemia have shown an increase in chromosomal aberrations particularly
       aneuploidy, long-arm deletions and translocations involving chromosomes 5, 7 and
       8 (Pedersen-Bjergaard et al, 1995). Individuals with chronic exposure to benzene
       tend to exhibit similar changes in chromosomes 5 and 7 of peripheral blood
       lymphocytes (Zhang et al, 1998).
       Chromosomal aberrations involving chromosomes 5, 7 and 8 of various cell lines,
       including blood CD34+ progenitor cells, have been reported to occur, in vitro, in
       response to low-dose hydroquinone exposure (Smith et al, 2000; Stillman et al,
       1997). In particular, CD34+ bone marrow cells were observed to lose chromosome
       7 accompanied by selective deletion of the long-arm of chromosome 5 (5q31) but
       no changes in chromosome 8 (Stillman et al, 2000). Stillman et al. (1999) have also

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          reported that while catechol does not alter cellular cytogenetics, a dose-dependent
          synergistic effect is observed between hydroquinone and catechol. The
          combination of metabolites induces changes in chromosome 5 not seen with
          hydroquinone alone, a result analogous to the synergistic effect on micronuclei
          formation in human lymphocytes described by Robertson et al. (1991).
          A study of patients with therapy-related AML identified a close correlation
          between the use of drugs with DNA-topoisomerase inhibitor activity and
          aberrations in chromosomes 5, 7 and 8 (Super et al, 1993). Topoisomerases are a
          class of nuclear proteins (endonucleases) that convert one topological version of
          DNA into another by catalyzing the breakage and reformation of DNA
          phosphodiester linkages. They are involved in DNA replication and transcription,
          DNA repair, chromosome segregation and maintain genomic stability. Due to the
          sulfhydryl-dependent nature of topoisomerases and the ability of several benzene
          metabolites to modify sulfhydryl groups, inhibition of topoisomerase activity by
          benzene metabolites has been proposed as a mechanism for leukaemia formation.
          Chen & Eastmond (1995) found no evidence for topoisomerase I inhibition by
          phenol, catechol, hydroquinone, benzoquinone or 1,2,4-benzenetriol at
          concentrations up to 1000 µM. Similarly, topoisomerase II activity was not
          inhibited by benzene metabolites at concentrations less than 500 µM with the
          exception of 1,2,4-benzenetriol which was inhibitory at 250 µM. The activation of
          phenol by a peroxidase and hydrogen peroxide system resulted in inhibition at 50
          µM and the products of this reaction, 2,2'-biphenol and 4,4'-biphenol were found
          to be inhibitory at 500 µM, whereas the peroxidase activation products of these
          compounds were inhibitory at 100 and 10 µM respectively. However, Parke and
          Williams (1953) failed to find any evidence for the in vivo formation of biphenol
          products after benzene exposure and there is evidence that these metabolites do not
          readily form in the presence of hydroquinone (Smith et al, 1989). In contrast, Hutt
          and Kalf (1996) found topoisomerase II activity to be inhibited by hydroquinone or
          benzoquinone at 6 and 3 µM respectively.
          In addition to modulation of topoisomerase activity, benzene metabolites can
          modify other nuclear proteins including tubulin (Pfeiffer & Metzler, 1996) and
          produce DNA-protein cross-links (Schoenfeld & Witz, 1999) which may contribute
          to chromosomal aberrations and the development of leukaemia. It has been
          postulated that chromosomal aberrations could result in inactivation of tumour
          suppressor genes, such as p53, activation of proto-oncogenes and altered
          expression of growth-factor and growth-factor receptor genes on the aberrant
          chromosomes (Irons and Stillman, 1996; Smith, 1996). Similarly, the formation of
          apurinic sites due to depurination by N-7 guanine adducts of benzene oxide (Gut et
          al, 1996) could result in misreplication of DNA and contribute to the development
          of leukaemia, as could oxidative DNA base lesions due to benzene-induced
          oxidative stress.

12.3.3 Tumours in Zymbal, Harderian, lacrimal and mammary glands
          In addition to haematopoietic abnormalities, rodents exposed to benzene develop
          solid tumours in the Zymbal, Harderian, lacrimal and mammary glands, although
          other organs and tissues may also be involved (Huff et al, 1989). The mechanisms
          by which benzene induces tumours in these glands have not been extensively
          investigated. Biochemical characterisation has revealed the presence of high levels
          of peroxidase enzymes which can activate phenolic metabolites of benzene to
          reactive species capable of modifying DNA and altering cellular functions as
          described above. Humans lack an anatomical equivalent of the Zymbal gland and
Benzene                                      113

       the human Harderian gland is only of rudimentary development and has not been
       characterised with respect to peroxidase activity.
       Studies by Low et al. (1989) indicate that neither benzene nor its metabolites
       accumulate in the rat Zymbal gland, a sebaceous gland of the external ear duct of
       rodents. However, examination of Zymbal gland tissue after oral administration of
       benzene revealed phenol and hydroquinone to constitute 3% and 30% respectively
       of unconjugated metabolites. Phenyl glucuronide accounted for 35% of conjugated
       metabolites but phenylsulfate could not be detected. The absence of phenylsulfate
       was attributed to a lack of sulfotransferase activity in this tissue. In contrast,
       Osborne et al. (1980) found the Zymbal gland to exhibit a high level of peroxidase
       activity indicating that activation of phenolic benzene metabolites could occur in
       this organ. Reddy et al. (1989a) subsequently identified DNA adducts in excised
       Zymbal glands after incubation with benzene or its metabolites. The combination
       of low sulfotransferase and high peroxidase activity would appear to be conducive
       to the formation of reactive metabolites in the Zymbal gland, thus facilitating
       tumour formation.
       Both lacrimal glands and the accessory lacrimal glands, the Harderian glands,
       develop tumours in response to benzene exposure. Biochemical characterisation of
       these glands has demonstrated the presence of high constitutive levels of
       lactoperoxidase (Morrison & Allen, 1966), which can activate phenolic metabolites
       of benzene to reactive species in the same manner as myeloperoxidase.
       Mammary gland tumours have been observed in rodents in response to benzene
       (Huff et al, 1989) and limited epidemiological evidence suggests an association
       between exposure to benzene or benzene-containing products and mammary
       tumours in humans (Hansen, 2000; Petralia et al, 1999; see Section 11.6.2). The
       mechanism for the formation of these mammary tumours is uncertain. Reddy et al.
       (1989b) failed to detect DNA adducts associated with the mammary gland of
       female rats after 10 weeks of benzene exposure, suggesting an epigenetic
       mechanism may be involved. However, as stated in Section 9, Low et al. (1989)
       found the distribution of radiolabel in female rats (Sprague-Dawley) to vary
       depending on the dose of [14C]-benzene administered. When comparing doses of
       benzene at 0.15, 1.5 and 15 mg/kg bw, the highest dose resulted in a substantial
       increase in the amount of radiolabel associated with the mammary gland and bone
       marrow compared to other tissues at the lesser doses. Mammary tissue is richly
       perfused with blood and has a high fat content which allows for the accumulation
       of benzene metabolites. It also contains lactoperoxidase which has been shown to
       metabolise phenolic compounds to reactive species (Monzani et al, 1997).
       Consequently, benzene metabolites may become activated within mammary tissue
       resulting in altered cellular function and carcinogenesis.

12.4   Interindividual variations in susceptibility

12.4.1 Gender effects
       While several studies have reported gender-dependent differences in the
       metabolism and/or toxicity of benzene in mice, there are no reliable data to indicate
       that there are gender differences in humans with respect to either the metabolism of
       benzene or susceptibility to benzene toxicity.
       Male Swiss (CD-1) mice exposed to benzene exhibited more severe benzene-
       related toxicity, including genotoxic effects, than females (Meyne and Legator,

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          1980; Ward et al, 1985). Similarly, suppression of bone marrow cellularity in male
          DBA/2 mice was greater than females after exposure to benzene (Luke et al,
          1988a). Corti and Snyder (1996) found, using Swiss Webster mice exposed to
          benzene (10 ppm) for 6 h over 10 days, that the number of erythoid colony forming
          units (CFU-E) had decreased in the bone marrow of adult-exposed males, in utero-
          exposed males and foetal male livers compared to female adults and foetuses. It
          was further shown by Corti and Snyder (1998), in vitro, that isolated CFU-E
          derived from male mice were more susceptible to individual benzene metabolites
          then female isolates.
          A marked gender-related difference was observed in the hepatic glutathione-S-
          transferase (GST) activity of CD-1 mice with the  isoform exhibiting
          approximately 25% greater activity towards trans,trans-muconaldehyde in the
          females compared to males (Goon et al, 1993). Investigations of gender-related
          differences in benzene metabolism by mouse bone marrow have not, as yet, been
          undertaken. Hu et al. (1993) observed that microsomes prepared from the kidneys
          (but not livers) of male mice (C3H/HeJ) possessed CYP2E1 activity up to 50-fold
          higher for acetaminophen metabolism compared to female mice. It was further
          observed that the administration of testosterone to female mice increased the
          CYP2E1 activity in the kidneys of females. Supporting evidence for the role of
          metabolic gender-differences was provided by Kenyon et al. (1995) who found that
          male mice (B6C3F1) excreted more hydroquinone glucuronide when dosed with
          phenol compared to female mice. In a subsequent study, Kenyon et al. (1998)
          found bone marrow levels of phenol and hydroquinone to be higher in male mice
          (B6C3F1) compared to female mice after exposure to benzene.
          Attempts to demonstrate gender differences in benzene metabolism in humans by
          comparing urinary metabolites (trans,trans-muconic acid and phenylmercapturic
          acid) to benzene exposure levels have produced negative results (Inoue et al, 1989;
          Inoue, 2000).

12.4.2 Genetic polymorphisms
          It has been observed that different strains of male mice (DBA/2, C57B1/B6 and
          B6C3F1) exhibit differing sensitivities to benzene when exposed under identical
          conditions (Luke et al, 1988b; Pirozzi et al, 1989) and that the metabolic profile of
          urinary benzene metabolites is strain-dependent (Longacre et al, 1981). These data
          suggest that individual responses to benzene may be genetically determined.
          Johnson & Lucier (1992) concluded from an analysis of trans,trans-muconic acid
          biomarker assays in humans that genetic variability may account, in part, for the
          variance between benzene exposure and urinary trans,trans-muconic acid
          concentrations. Subsequently, it has been postulated that the presence of genetically
          determined differences in enzyme expression or activity, genetic polymorphisms,
          may partially account for the toxicity associated with benzene exposure (Aksoy,
          1985; Moran et al, 1999; Rothman et al, 1997). Studies of cases involving familial
          susceptibility to benzene (Aksoy, 1985) tend to support this view. Genetic
          differences involved in the metabolism of benzene can modify its rate of
          metabolism, the profile of metabolites produced and metabolite
          activation/detoxification pathways. Such changes have been quantified by analysis
          of the urinary metabolites of benzene, phenylmercapturic acid and trans,trans-
          muconic acid (Rossi et al, 1999).




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CYP2E1

The metabolism of benzene by hepatic CYP2E1 is the critical first step in the
development of benzene toxicity as the enzyme is responsible for the formation of
phenol and its secondary metabolism to hydroquinone (Guengerich et al, 1991).
Genetic polymorphisms associated with CYP2E1 from different racial groups have
been identified, with frequencies ranging from 2-27% (Kato et al, 1992) and
changes in transcriptional activity of the enzyme in response to mutations have
been described (Hayashi et al, 1991). Seaton et al. (1994) observed that the
CYP2E1 activity of microsomes prepared from the livers of trauma victims varied
13-fold with respect to benzene metabolism. However, as DNA analysis was not
undertaken, it is not known if the differences were genetically determined.
Rothman et al. (1997) showed in a study of 50 workers exposed to benzene that
CYP2E1 genetic polymorphisms were not associated with benzene toxicity. In
another study of 59 workers exposed to benzene, although considerable variation in
urinary metabolite markers was observed, the subjects did not exhibit
polymorphisms associated with CYP2E1 (Rossi et al, 1999).
A cross-species analysis of the expression of CYP2E1 in the bone marrow of mice,
rats and rabbits and human CD34+ stem cells found the enzyme to be present in all
species tested. While the intra- and interspecies variability between mice and rats
was small with relatively low enzyme activities, rabbits exhibited enzyme activities
an order of magnitude greater (Bernauer et al, 2000).

Glutathione-S-transferase

The enzymatic conjugation of GSH to a number of benzene metabolites,
particularly benzene oxide, trans,trans-muconaldehyde and quinones, occurs via
the action of glutathione-S-transferase (GST) (Goon et al, 1993b; Jerina et al,
1968). It has been postulated that GST genetic polymorphisms are positively
correlated with increased risk of oxidative stress (Hayes & Strange, 1995) and
cancer (Strange et al, 1998). Xu et al. (1998b) found a significant association (p
<0.05) between benzene exposure (0.71 ppm TWA), sister chromatid exchanges
and the GSTT1 genotype in a study of 23 workers. Hsieh et al. (1999) examined the
role of GST polymorphism in workers exposed to benzene and found that those
with the GSTT1 and GSTM1 variants of the enzyme, which exhibit reduced
enzymatic activity, were more likely (p = 0.046) to have reduced white blood cell
counts on exposure to high levels of benzene.

Epoxide hydrolase

Epoxide hydrolase, which converts benzene oxide to benzene dihydrodiol, has the
potential to regulate the formation of trans,trans-muconaldehyde. Analysis of 40
transplant-quality human liver samples for interindividual variation in epoxide
hydrolase activity revealed an approximately 8-fold difference in enzymatic
activity and microsomal epoxide hydrolase protein levels were highly correlated
with that activity. In contrast, neither enzymatic activity nor microsomal epoxide
hydrolase protein levels correlated with microsomal epoxide hydrolase RNA levels
which varied by 49-fold. Polymorphisms in amino acid loci of epoxide hydrolase
accounted, in part, for the differences in enzyme activity (Hassett et al, 1997).

NAD(P)H:quinone oxidoreductase (NQO1)

NQO1 catalyzes the two-electron reduction of quinones to their corresponding
hydroquinone form (Lind et al, 1982). Twerdok et al. (1992) reported considerable

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          strain differences in the basal and inducible levels of NQO1 between C57B1/6 and
          DBA/2-derived mouse bone marrow stromal cells. The basal and maximal
          inducible activity of NQO1 in C57B1/6-derived stromal cells was approximately 3-
          and 5-fold greater respectively than that of DBA/2-derived cells.
          Traver et al. (1992) identified a point mutation in the human NQO1 gene (609CT)
          that results in loss of enzymatic activity in the protein. Thus individuals
          homozygous for the mutation possess no NQO1 activity, while heterozygous
          individuals exhibit reduced enzymatic activity. It has been estimated, using a
          reference population, that the frequency of the mutation is 13% (Rosvold et al,
          1995). Analysis of several ethnic groups has shown that homozygous individuals
          range between 5-22% and heterozygous individuals from 34-52% of the population
          (Kelsey et al, 1997). The study of Rothman et al. (1997) demonstrated a correlation
          between NQO1 genetic polymorphism and benzene toxicity among 50 workers
          exposed to benzene. Rossi et al. (1999) identified a high frequency of NQO1
          genetic polymorphism (42.7% reduced activity and 8.3% no activity) amongst 59
          workers exposed to benzene and urinary excretion of S-phenylmercapturic acid was
          significantly lower in individuals lacking NQO1 activity. An increased prevalence
          of the 609CT mutation has been found in a study of 104 patients diagnosed with
          myeloid leukemias (Larson et al, 1999). However, a study of a group of six related
          individuals predisposed to cancer showed that the NQO1 609CT transversion did
          not correlate with NQO1 activity in heterozygous individuals, suggesting that either
          the 609CT transversion has no effect on NQO1 activity or that post-transcriptional
          regulation alters the activity of the modified enzyme (Kuehl et al, 1995).
          Further investigations, in vitro, have found NQO1 to be inducible in wild-type
          (C/C) human bone marrow cells on exposure to the benzene metabolites
          hydroquinone and catechol. In contrast, cells homozygous for the 609CT mutation
          (T/T) did not express NQO1 in response to hydroquinone treatment whereas
          heterozygous cells (C/T) exhibited intermediate induction (Moran et al, 1999).

12.4.3 Environmental influences
          In addition to genetic influences, the susceptibility of an individual to benzene
          toxicity may also be influenced by environmental or lifestyle factors. Generally, the
          role of environmental factors in modifying benzene toxicity have not been
          adequately studied. Reviews of environmental influences on solvent toxicity,
          including benzene, have been published (Medinsky et al, 1994; Sato, 1991).

          Alcohol

          As discussed in Section 9, CYP2E1 is the initial enzyme responsible for the
          metabolism of benzene to phenolic metabolites. Studies have shown a number of
          substances including alcohol (ethanol) to induce hepatic CYP2E1 activity
          (Johansson & Ingelman-Sundberg, 1988; Koop et al, 1989). Alcohol consumption
          by rats and rabbits resulted in increased microsomal metabolism of benzene
          (Johansson & Ingelman-Sundberg, 1988; Nakajima et al, 1985) and increased
          benzene-mediated myelotoxicity in rats (Nakajima et al, 1985). Consequently,
          alcohol consumption by individuals exposed to benzene may result in enhanced
          metabolite formation and increased risk of myelotoxicity.

          Toluene

          Toluene acts as a substrate for CYP2E1 (Nakajima et al, 1992) and thus, in the
          presence of benzene, can act as an inhibitor of benzene metabolism. Andrews et al.
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       (1977) demonstrated the inhibition of benzene metabolism by the co-administration
       of toluene to male Swiss mice. Urinary benzene metabolites were significantly
       decreased (p <0.01) and the amount of exhaled benzene increased in toluene- and
       benzene-treated animals compared to control benzene-treated animals. While the
       tissue concentration of benzene did not alter with toluene treatment, the
       concentration of total benzene metabolites was significantly reduced (p <0.05) in
       various tissues including blood and bone marrow. Inoue et al. (1989) showed that
       workers exposed concurrently to benzene and toluene produced significantly less (p
       <0.01) urinary trans,trans-muconic acid compared to workers exposed only to
       benzene. However, in a study in which urinary phenylmercapturic acid was used as
       a biomarker for workers exposed to benzene, no correlation with toluene exposure
       was found (Inoue et al, 2000).

       Non-steroidal anti-inflammatory drugs

       Cyclooxygenase activity within bone marrow contributes to benzene-mediated
       bone marrow toxicity by participating in the oxidation of phenolic metabolites to
       reactive species and by the conversion of macrophage-derived arachidonic acid to
       PGE2, an inhibitor of stem cell proliferation. Non-steroidal anti-inflammatory drugs
       (NSAIDs) such as aspirin and indomethacin are potent inhibitors of
       cyclooxygenase activity (Randall et al, 1980; Roth et al, 1975). The administration
       of NSAIDs, prior to benzene exposure, has been shown to diminish the bone
       marrow toxicity associated with benzene in mice (Kalf et al, 1989; Pirozzi et al,
       1989). The routine use of NSAIDs may confer some protection from the effects of
       benzene exposure.

12.5   Summary
       Exposure to benzene can result in bone marrow toxicity in several species in
       addition to leukaemia in humans and solid tumours in other animal species. In
       order for bone marrow toxicity to occur, benzene must first be metabolised by the
       liver to intermediate metabolites. These metabolites become localised within the
       bone marrow where they undergo activation by peroxidase enzymes, particularly
       myeloperoxidase which is found in large amounts in bone marrow, and, to a lesser
       extent, by cyclooxygenase. While individual benzene metabolites appear not to
       induce bone marrow toxicity, the combination of phenol and hydroquinone have
       been shown to induce the same effects on bone marrow as benzene. This effect
       appears to be due to the ability of phenol to act as a co-oxidant in the activation of
       hydroquinone to the semiquinone and benzoquinone by myeloperoxidase.
       Subsequent changes in cellular function result in altered growth factor production
       with inhibition of bone marrow stem cell proliferation, differentiation and
       maturation. The oxidation of hydroquinone also results in the formation of reactive
       oxygen species. Damage to cells by these species can result from DNA adduct
       formation, DNA base modification, chromosomal aberrations and changes to
       intracellular redox status, particularly depletion of glutathione and oxidation of
       protein sulfhydryl groups. Damaged cells not deleted by apoptosis and which
       possess activated oncogenes or damaged tumour suppressor genes may begin to
       proliferate as clonal lines, which may result in leukaemia in humans or solid
       tumours in animals.
       While a number of gender-related differences have been described in the response
       of rodents to benzene exposure, there is no evidence for such differences in the
       response of humans. However, humans do exhibit differences in the expression and

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