A systematic review and meta-analysis of haematological malignancies in residents living near petrochemical facilities

Abstract

Background:The petrochemical industry is a major source of hazardous and toxic air pollutants that are recognised to have mutagenic and carcinogenic properties. A wealth of occupational epidemiology literature exists around the petrochemical industry, with adverse haematological effects identified in employees exposed to 'low' concentrations of aromatic hydrocarbons (benzene, toluene, ethylbenzene, and xylene). Releases from the petrochemical industry are also thought to increase the risk of cancer incidence in fenceline communities. However, this emerging and at times inconclusive evidence base remains fragmented. The present study's aim was to conduct a systematic review and meta-analysis of epidemiological studies investigating the association between incidences of haematological malignancy and residential exposure to the petrochemical industry. Methods: Epidemiological studies reporting the risk of haematological malignancies (Leukaemia, Hodgkin's lymphoma, Non-Hodgkin's lymphoma, and Multiple myeloma) were included where the following criteria were met: (i) Cancer incidence is diagnosed by a medical professional and coded in accordance to the International Classification of Diseases; (ii) A clear definition of fenceline communities is provided, indicating the proximity between exposed residents and petrochemical activities; and (iii) Exposure is representative of normal operating conditions, not emergency events. Two investigators independently extracted information on study characteristics and outcomes in accordance with PRISMA and MOOSE guidelines. Relative risks and their 95% confidence intervals were pooled across studies for the four categories of haematological malignancy, using a random effects meta-analysis. Results: The systematic review identified 16 unique studies, which collectively record the incidence of haematological malignancies across 187,585 residents living close to a petrochemical operation. Residents from fenceline communities, less than 5 km from a petrochemical facility (refinery or manufacturer of commercial chemicals), had a 30% higher risk of developing Leukaemia than residents from communities with no petrochemical activity. Meanwhile, the association between exposure and rarer forms of haematological malignancy remains uncertain, with further research required. Conclusions: The risk of developing Leukaemia appears higher in individuals living near a petrochemical facility. This highlights the need for further policy to regulate the release of carcinogens by industry.

Cancer Incidence and Mortality among Petroleum Industry Workers and Residents Living in Oil Producing Communities: A Systematic Review and Meta-Analysis

“…Their results showed elevated meta-relative risks of mesothelioma, malignant skin melanoma, and acute lymphoid leukemia and no elevated risks of total leukemia, acute non-lymphocytic leukemia, chronic lymphocytic leukemia, chronic myeloid leukemia, multiple myeloma, non-Hodgkin’s lymphoma (NHL), and lung and kidney cancers. The most recent review of residents near petroleum industry sites has also found elevated risks for leukemia (the review only focused on hematological malignancy) [ 11 ].…”

Epigenetic Effects of Benzene in Hematologic Neoplasms: The Altered Gene Expression

“…A systematic review recognized 16 reports, which jointly evaluated the occurrence of hematological malignancies across 187,585 residents residing close to a refinery. Inhabitants from the areas less than 5 km from a petrochemical facility presented a 30% higher risk of developing hematological malignancies than habitants from areas with no petrochemical activity [ 33 ].…”

Environmental and occupational exposure among cancer patients in Mato Grosso, Brazil

“…Regarding its carcinogenicity, specifically in relation to its chronic exposure, quantitative changes in blood cells are reported, such as leukopenia, thrombocytopenia, and erythropenia, and, among the most serious effects, acute and chronic leukemias 14 . A systematic review with meta-analysis conducted by Jephcote et al 15 evaluated residents who lived near petrochemical centers and recorded a higher incidence of hematologic neoplasia in relation to the general population. In Brazil, the Brazilian National Cancer Institute (INCA), together with the Ministry of Health, developed a manual on cancer surveillance related to work and the environment, relating, among other chemical substances, benzene as the main cause of leukemia among workers in the petrochemical sector, including those who distributed and traded fossil fuels, especially petrol 16 .…”