Environmental Science and Pollution Research

, Volume 26, Issue 11, pp 10552–10561 | Cite as

The hematologic effects of BTEX exposure among elderly residents in Nanjing: a cross-sectional study

  • Qi Chen
  • Hong Sun
  • Jiayao Zhang
  • Yan Xu
  • Zhen DingEmail author
Research Article


Few studies have examined the effects of environmental concentrations of benzene, toluene, ethylbenzene, and xylene (BTEX) on the hematologic system of residents near a petrochemical complex. This study evaluated the potential effects of blood BTEX concentrations on the hematologic parameters of residents in a community near a petrochemical complex (contaminated group) and another community free of known petrochemical pollution (control group). Volunteer residents were randomly recruited. Each participant completed a questionnaire and donated blood samples to evaluate blood BTEX concentrations and hematologic parameters. We found the mean concentrations of blood BTEX of the contaminated group were 1.2 to 6.7 times higher than the control group. Multiple hematologic parameters of participants were significantly different between the two study groups. Inverse associations were found for ln-transformed blood benzene concentrations with mean corpuscular hemoglobin concentration (MCHC) (β = − 2.75) and platelet counts (β = −8.18). Several weaker associations were also observed between other compounds and multiple hematologic parameters. Our results suggest that the residents living near petrochemical complexes have higher blood BTEX concentrations. Furthermore, the increased blood BTEX levels in residents are associated with the reduction in RBC counts, hemoglobin concentration, hematocrit, MCHC, and platelet counts. This study provided particularly important information for the health risk assessment of residents living near petrochemical complexes.


BTEX Benzene Blood Hematologic parameters Petrochemical 



benzene, toluene, ethylbenzene, and xylene


body mass index


generalized linear models




limit of detection


mean corpuscular hemoglobin concentration


mean corpuscular volume


red blood cell


standard deviation


volatile organic compounds


white blood cell


Authors’ contributions

QC and HS contributed to the study design, data procurement, results interpretation, and drafting of the article. JZ was involved in collection of the data. ZD and YX took part in the study design, supervision of the research, data procurement and results interpretation. All authors read and gave their approval for publication.


This study was supported by funds from the Key Talent Project for Medical Young Scholars of Jiangsu Province (QNRC2016551) and Jiangsu social development project (BE2018745).

Compliance with ethical standards

Availability of data and materials

The data that support the findings of this study are available from Jiangsu Provincial Commission of Health and Family Planning; however, restrictions apply regarding the availability of these data, which were used under a license for the current study, and the data are not publicly available. Data are however available from the authors upon reasonable request and with permission of Jiangsu Provincial Commission of Health and Family Planning.

Consent for publication

Not applicable.

Ethics approval and consent to participate

The study protocol was approved by the Ethic Commission of Jiangsu Provincial Center for Disease Control and Prevention; all study participants provided written informed consent.

Competing interests

The authors declare that they have no competing interests.


  1. Aksoy M (1989) Hematotoxicity and carcinogenicity of benzene. Environ Health Perspect 82:193–197CrossRefGoogle Scholar
  2. Ashley DL, Prah JD (1997) Time dependence of blood concentrations during and after exposure to a mixture of volatile organic compounds. Arch Environ Health 52:26–33. CrossRefGoogle Scholar
  3. Ashley DL, Bonin MA, Cardinali FL, McCraw JM, Wooten JV (1996) Measurement of volatile organic compounds in human blood. Environ Health Perspect 104(Suppl):871–877. Google Scholar
  4. Bird MG, Wetmore BA, Letinski DJ, Nicolich M, Chen M, Schnatter AR, Whitman FT (2010) Influence of toluene co-exposure on the metabolism and genotoxicity of benzene in mice using continuous and intermittent exposures. Chem Biol Interact 184:233–239. CrossRefGoogle Scholar
  5. Blount B, Kobelski R, Mcelprang D, Ashley D, Morrow J, Chambers D, Cardinali F (2006) Quantification of 31 volatile organic compounds in whole blood using solid-phase microextraction and gas chromatography–mass spectrometry☆. J Chromatogr B 832:292–301. CrossRefGoogle Scholar
  6. Bolden AL, Kwiatkowski CF, Colborn T (2015) New look at BTEX: are ambient levels a problem? Environ Sci Technol 49:5697–5703. CrossRefGoogle Scholar
  7. Brugnone F, Perbellini L, Maranelli G, Romeo L, Guglielmi G, Lombardini F (1992) Reference values for blood benzene in the occupationally unexposed general population. Int Arch Occup Environ Health 64:179–184CrossRefGoogle Scholar
  8. Casale T, Sacco C, Ricci S, Loreti B, Pacchiarotti A, Cupelli V, Arcangeli G, Mucci N, Antuono V, de Marco F, Tomei G, Tomei F, Rosati MV (2016) Workers exposed to low levels of benzene present in urban air: assessment of peripheral blood count variations. Chemosphere 152:392–398. CrossRefGoogle Scholar
  9. Chambers DM, Ocariz JM, McGuirk MF, Blount BC (2011) Impact of cigarette smoking on volatile organic compound (VOC) blood levels in the U.S. population: NHANES 2003–2004. Environ Int 37:1321–1328. CrossRefGoogle Scholar
  10. Doherty BT, Kwok RK, Curry MD, Ekenga C, Chambers D, Sandler DP, Engel LS (2017) Associations between blood BTEXS concentrations and hematologic parameters among adult residents of the U.S. Gulf States. Environ Res 156:579–587. CrossRefGoogle Scholar
  11. Esplugues A, Ballester F, Estarlich M, Llop S, Fuentes-Leonarte V, Mantilla E, Iñiguez C (2010) Indoor and outdoor air concentrations of BTEX and determinants in a cohort of one-year old children in Valencia, Spain. Sci Total Environ 409:63–69. CrossRefGoogle Scholar
  12. Galbraith D, Gross SA, Paustenbach D (2010) Benzene and human health: a historical review and appraisal of associations with various diseases. Crit Rev Toxicol 40:1–46. CrossRefGoogle Scholar
  13. Goldstein BD (1977) Benzene toxicity: a critical evaluation: hematotoxicity in humans. J Toxicol Environ Health Suppl 2:69–105Google Scholar
  14. Hristeva-Mirtcheva V (1998) Changes in the peripheral blood of workers with occupational exposure to aromatic hydrocarbons. Int Arch Occup Environ Health 71(Suppl):S81–S83Google Scholar
  15. Hsu C-Y, Chiang H-C, Shie R-H, Ku CH, Lin TY, Chen MJ, Chen NT, Chen YC (2018) Ambient VOCs in residential areas near a large-scale petrochemical complex: spatiotemporal variation, source apportionment and health risk. Environ Pollut 240:95–104. CrossRefGoogle Scholar
  16. Jia C, Yu X, Masiak W (2012) Blood/air distribution of volatile organic compounds (VOCs) in a nationally representative sample. Sci Total Environ 419:225–232. CrossRefGoogle Scholar
  17. Khuder SA, Youngdale MC, Bisesi MS, Schaub EA (1999) Assessment of complete blood count variations among workers exposed to low levels of benzene. J Occup Environ Med 41:821–826CrossRefGoogle Scholar
  18. Kirkeleit J, Riise T, Bjørge T, Christiani DC (2013) The healthy worker effect in cancer incidence studies. Am J Epidemiol 177:1218–1224. CrossRefGoogle Scholar
  19. Koh D-H, Jeon H-K, Lee S-G, Ryu H-W (2015) The relationship between low-level benzene exposure and blood cell counts in Korean workers. Occup Environ Med 72:421–427. CrossRefGoogle Scholar
  20. Lan Q, Zhang L, Li G, Vermeulen R, Weinberg RS, Dosemeci M, Rappaport SM, Shen M, Alter BP, Wu Y, Kopp W, Waidyanatha S, Rabkin C, Guo W, Chanock S, Hayes RB, Linet M, Kim S, Yin S, Rothman N, Smith MT (2004) Hematotoxicity in workers exposed to low levels of benzene. Science 306:1774–1776. CrossRefGoogle Scholar
  21. Lee CR, Yoo CI, Lee JH, Kim SR, Kim Y (2002) Hematological changes of children exposed to volatile organic compounds containing low levels of benzene. Sci Total Environ 299:237–245CrossRefGoogle Scholar
  22. Lin YS, Egeghy PP, Rappaport SM (2008) Relationships between levels of volatile organic compounds in air and blood from the general population. J Expo Sci Environ Epidemiol 18:421–429. CrossRefGoogle Scholar
  23. Liu B, Liang D, Yang J, Dai Q, Bi X, Feng Y, Yuan J, Xiao Z, Zhang Y, Xu H (2016) Characterization and source apportionment of volatile organic compounds based on 1-year of observational data in Tianjin, China. Environ Pollut 218:757–769. CrossRefGoogle Scholar
  24. Lubin JH, Colt JS, Camann D, Davis S, Cerhan JR, Severson RK, Bernstein L, Hartge P (2004) Epidemiologic evaluation of measurement data in the presence of detection limits. Environ Health Perspect 112:1691–1696CrossRefGoogle Scholar
  25. Masih A, Lall AS, Taneja A, Singhvi R (2017) Exposure profiles, seasonal variation and health risk assessment of BTEX in indoor air of homes at different microenvironments of a terai province of northern India. Chemosphere 176:8–17. CrossRefGoogle Scholar
  26. Mchale CM, Zhang L, Smith MT (2012) Current understanding of the mechanism of benzene-induced leukemia in humans: implications for risk assessment. Carcinogenesis 33:240–252. CrossRefGoogle Scholar
  27. Moszczynski P, Lisiewicz J (1982) T and B cells and occupational exposure to benzene and its homologues (with regard to other blood cells). Rev Esp Oncol 29:49–55Google Scholar
  28. Moszczyński P, Lisiewicz J (1983) Hematological indices of peripheral blood in workers occupationally exposed to benzene, toluene and xylene. Zentralbl Bakteriol Mikrobiol Hyg B 178:329–339Google Scholar
  29. Oiamo TH, Johnson M, Tang K, Luginaah IN (2015) Assessing traffic and industrial contributions to ambient nitrogen dioxide and volatile organic compounds in a low pollution urban environment. Sci Total Environ 529:149–157. CrossRefGoogle Scholar
  30. Paciência I, Madureira J, Rufo J, Moreira A, Fernandes EO (2016) A systematic review of evidence and implications of spatial and seasonal variations of volatile organic compounds (VOC) in indoor human environments. J Toxicol Environ Health B Crit Rev 19(2): 47–64.
  31. Pelallo-Martínez NA, Batres-Esquivel L, Carrizales-Yañez L, Díaz-Barriga FM (2014) Genotoxic and hematological effects in children exposed to a chemical mixture in a petrochemical area in Mexico. Arch Environ Contam Toxicol 67:1–8. CrossRefGoogle Scholar
  32. Protano C, Andreoli R, Manini P, Guidotti M, Vitali M (2012) A tobacco-related carcinogen: assessing the impact of smoking behaviours of cohabitants on benzene exposure in children. Tob Control 21:325–329. CrossRefGoogle Scholar
  33. Qu Q, Shore R, Li G, Jin X, Chi Chen L, Cohen B, Melikian AA, Eastmond D, Rappaport SM, Yin S, Li H, Waidyanatha S, Li Y, Mu R, Zhang X, Li K (2002) Hematological changes among Chinese workers with a broad range of benzene exposures. Am J Ind Med 42:275–285. CrossRefGoogle Scholar
  34. Sarigiannis DA, Karakitsios SP, Gotti A, Liakos IL, Katsoyiannis A (2011) Exposure to major volatile organic compounds and carbonyls in European indoor environments and associated health risk. Environ Int 37:743–765. CrossRefGoogle Scholar
  35. Song Y, Shao M, Liu Y, Lu S, Kuster W, Goldan P, Xie S (2007) Source apportionment of ambient volatile organic compounds in Beijing. Environ Sci Technol 41:4348–4353CrossRefGoogle Scholar
  36. Tohon HG, Fayomi B, Valcke M, Coppieters Y, Bouland C (2015) BTEX air concentrations and self-reported common health problems in gasoline sellers from Cotonou, Benin. Int J Environ Health Res 25:149–161. CrossRefGoogle Scholar
  37. Tong L, Liao X, Chen J, Xiao H, Xu L, Zhang F, Niu Z, Yu J (2013) Pollution characteristics of ambient volatile organic compounds (VOCs) in the southeast coastal cities of China. Environ Sci Pollut Res 20:2603–2615. CrossRefGoogle Scholar
  38. Wetmore BA, Struve MF, Gao P, Sharma S, Allison N, Roberts KC, Letinski DJ, Nicolich MJ, Bird MG, Dorman DC (2008) Genotoxicity of intermittent co-exposure to benzene and toluene in male CD-1 mice. Chem Biol Interact 173:166–178. CrossRefGoogle Scholar
  39. World Health Organization Regional Office for Europe (2000) Air Quality Guidelines for Europe SecondEdition. WHO Regional Publications, European Series, No. 91. Accessed 10 Feb 2019
  40. Yoon BI, Hirabayashi Y, Kawasaki Y et al (2001) Mechanism of action of benzene toxicity: cell cycle suppression in hemopoietic progenitor cells (CFU-GM). Exp Hematol 29:278–285CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Qi Chen
    • 1
  • Hong Sun
    • 1
  • Jiayao Zhang
    • 2
  • Yan Xu
    • 1
  • Zhen Ding
    • 1
    Email author
  1. 1.Jiangsu Provincial Center for Disease Control and PreventionNanjingPeople’s Republic of China
  2. 2.Nanjing Medical UniversityNanjingPeople’s Republic of China

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