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Which Workplace Chemicals Raise the Risk for Leukemia?

Posted on April 13, 2022
Medically reviewed by
Todd Gersten, M.D.
Article written by
Nyaka Mwanza

Almost 400,000 people in the United States are living with leukemia or are in remission. As many as 2.8 percent of cases are thought to be due to workplace exposure to cancer-causing chemicals (carcinogens).

The carcinogens associated with an increased risk of leukemia are benzene, ethylene oxide, and formaldehyde. Ultimately, more research is needed to understand these chemicals and the various ways they interact with our bodies — and with other leukemia risk factors — to contribute to the development of leukemia.

Here’s what to know about these chemicals, how they affect the risk of different types of leukemia, and what you can do to minimize your risk if you’ve been exposed.

Benzene

Benzene is a colorless liquid with a noticeable, sweet smell. It is a type of chemical known as an organic solvent. Organic solvents are commonly used to dissolve grease and oil.

This chemical is used to produce a range of goods, including detergents, dyes and inks, herbicides, insecticides, rubbers, and plastics. It is also used in several industrial manufacturing processes. Benzene is also a by-product of coal and petroleum as energy sources — motor vehicle exhaust contains benzene.

Benzene exposure can happen by inhalation, swallowing, or by getting it on the skin or eyes.

Examples of people who may be at higher risk of exposure to benzene at work include:

  • Factory workers at steel or rubber processing plants
  • Workers in the printing industry or who work in contact with printing inks
  • Firefighters who come in contact with toxic smoke
  • Gas station attendants and vehicle repair workers

Benzene exposure has been strongly associated with acute myeloid leukemia (AML). While data to support the association is not as strong, benzene is also linked to:

  • Acute lymphocytic leukemia
  • Chronic lymphocytic leukemia
  • Other blood cancers like multiple myeloma and non-Hodgkin lymphoma

Long-term exposure to benzene is thought to increase the risk of leukemia by seven times. Benzene poisoning is linked to a 71-fold increase in leukemia risk.

Ethylene Oxide

Ethylene oxide is a flammable chemical with a sweet smell. At room temperature, ethylene oxide is a gas. Ethylene oxide is used as a pesticide or a sterilizing agent and is frequently used as an ingredient in chemical products such as antifreeze. It can break down and damage DNA, which gives ethylene oxide its cancer-causing properties.

Ethylene oxide exposure can happen by breathing or swallowing the chemical. People at risk of ethylene oxide exposure include people who work with the chemical as well as those who live near industrial facilities that use or make ethylene oxide.

Ethylene oxide has been linked to an increased risk of lymphocytic leukemias.

Formaldehyde

Formaldehyde is a colorless, flammable chemical with a very strong odor. It’s a fungicide and germicide, and it’s also used as a disinfectant. Formaldehyde exposure occurs by breathing it in in its gas or vapor form or by absorption of liquid formaldehyde through the skin.

Formaldehyde is frequently used in the industrial and manufacturing sectors, often to produce other chemicals. It is also a preservative used in mortuaries or funeral homes and medical laboratories.

Two million workers in the U.S. have jobs that require them to work in an environment that has formaldehyde. Formaldehyde exposure is a potential occupational hazard among:

  • Agricultural workers who work with livestock in close settings
  • Construction workers working with materials made from resin
  • Manufacturers of plastics, resins, and foam insulation
  • Morticians, embalmers, and funeral directors involved in embalming
  • Beauticians working with some dyes

Formaldehyde, along with other cancer-causing chemicals, is also present in cigarette smoke.

Formaldehyde is associated with higher rates of AML and chronic myeloid leukemia. Formaldehyde is also linked to higher rates of death among people who work in embalming or in other industries that work closely with large quantities of formaldehyde.

Reducing Your Risk

Risk factors may increase the likelihood of developing a health condition. However, many people with risk factors don’t develop leukemia, and some people with no risk factors do develop the condition. It isn’t usually possible to determine whether or not exposure to a particular substance is the cause of a person’s cancer.

Coming into contact with a carcinogen does not necessarily mean you will get cancer. The risk may depend on factors including:

  • What chemical you were exposed to
  • How often or how long you were exposed to it
  • What concentrations you were exposed to

Also important is when in your life you were exposed. For instance, chemical exposure while in the womb may be significantly more impactful than exposure as an adult. Research suggests that parents who are exposed to certain toxins in the workplace see higher rates of leukemia in their children.

It’s not yet possible to prevent leukemia because there isn’t an exact known cause for most types of leukemia. Avoiding factors that could put you at risk is the best leukemia-prevention method. While you may not always be able to avoid chemicals that are a key part of your occupation, there are ways to reduce your exposure to carcinogens to help reduce your risk of leukemia.

Education and Understanding

You can neither avoid nor protect yourself if you don’t know what exactly poses a threat to you and your health. Understanding which chemicals are common in your work setting is an important part of managing your leukemia risk. In some cases, employers are required to disclose which hazardous chemicals employers may be exposed to in the course of doing their job.

Protective Measures at the Workplace

Various agencies work in tandem to regulate occupational cancer hazards and provide a safe work environment for those working near toxic or hazardous substances. In the U.S., employers are mandated by federal regulators to take protective measures against on-the-job chemical exposures. These measures could include providing and requiring protective clothing or equipment, such as respirators, for employees.

Employers are also required to keep known hazardous chemicals in the environment below maximum levels. These maximum levels are defined by regulatory agencies. Employers can take many actions to reduce the amounts of hazardous chemicals in the workplace. These include:

  • Limiting staff exposure
  • Ensuring adequate ventilation
  • Maintaining moderate temperatures
  • Reducing humidity levels

Because ethylene oxide is very flammable, highly explosive, and extremely reactive, equipment used to process this chemical usually has tight closures and highly automated systems. This limits the amount of direct contact employees have with the chemical and decreases risk of occupational exposure.

If you are exposed to benzene in your workplace, the U.S. Centers for Disease Control and Prevention (CDC) has more information to help you protect yourself.

Proactive Health Care Measures

Screening is important for early detection and treatment of certain cancers. In many cases, the sooner you find a cancer and start treating it, the better your chances for living a long and full life.

Find Your Team

MyLeukemiaTeam is the social network for people with leukemia and their loved ones. More than 104,000 members come together to ask questions, give advice, and share their experiences with others who understand life with leukemia.

Do you think workplace chemicals contributed to your risk of leukemia? Share your thoughts in the comments below or start a discussion on MyLeukemiaTeam.

References
  1. Facts and Statistics Overview — Leukemia & Lymphoma Society
  2. OSH Answers Fact Sheets: Occupational Cancer — Canadian Centre for Occupational Health and Safety
  3. Benzene — National Cancer Institute
  4. Ethylene Oxide — National Cancer Institute
  5. Formaldehyde — National Cancer Institute
  6. Benzene: General Information — GOV.UK
  7. Benzene and Cancer Risk — American Cancer Society
  8. Facts 2020-2021 — Leukemia & Lymphoma Society
  9. Association of 13 Occupational Carcinogens in Patients With Cancer, Individually and Collectively, 1990-2017 — JAMA Network Open
  10. Benzene — Centers for Disease Control
  11. Benzene in Motor Vehicle Repair — Health and Safety Executive
  12. Benzene Induces Rapid Leukemic Transformation After Prolonged Hematotoxicity in a Murine Model — Nature Research
  13. OSHA Fact Sheet: Ethylene Oxide — Occupational Safety and Hazard Administration
  14. Formaldehyde — American Cancer Society
  15. Formaldehyde — Centers for Disease Control
  16. Formaldehyde Exposure and Acute Myeloid Leukemia: A Review of the Literature — Medicina
  17. Risk Factors for Chronic Myelogenous Leukemia (CML) — Canadian Cancer Society
  18. Work-Related Leukemia: A Systematic Review — Journal of Occupational Medicine and Toxicology
  19. Chemicals, Cancer, and You — Agency for Toxic Substances and Disease Registry
  20. The Cal/OSHA Hazard Communication Regulation — A Guide for Employers That Use Hazardous Chemicals — Department of Industrial Relations Division of Occupational Safety and Health
  21. Facts About Benzene — Centers for Disease Control and Prevention
  22. Cancer-Causing Substances in the Environment — National Cancer Institute
  23. Known and Probable Human Carcinogens — American Cancer Society

All updates must be accompanied by text or a picture.
Todd Gersten, M.D. is a hematologist-oncologist at the Florida Cancer Specialists & Research Institute in Wellington, Florida. Review provided by VeriMed Healthcare Network. Learn more about him here.
Nyaka Mwanza has worked with large global health nonprofits focused on improving health outcomes for women and children. Learn more about her here.

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