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Background  Pollutants released from the petrochemical industry are thought to increase the risk of mortality in fence-line communities, yet the results from previous studies are often inconsistent and lack a global perspective, hampered by the absence of cohesive cross-country research.    Objectives  To provide the first Pan-European analysis of benzene exposures from the petrochemical industry, connecting polluting practices to pollution episodes and disparities in regional mortality rates, identifying the measures of best environmental practice to mitigate adverse outcomes.    Methods  The activity, classification and location of onshore petrochemical facilities within EU-28 Member States were extracted from the ‘European Pollutant Release and Transfer Register’ (E-PRTR), which holds records on 31,753 industrial operations for the reporting period of 2007–15. Parent company records were collected from the Moody's Analytics Amadeus database of 487,338 active companies across Europe. The EUROSTAT census provided records of income, life expectancy, and the underlying demographics used to calculate standardised health outcomes based on 9,936 sub-populations within the NUTS2 regions. The European Environment Agency provided ambient concentrations of benzene from 579 air quality stations. Bayesian multilevel models were constructed to account for variability caused by spatial hierarchical structures, uncertainty in the estimates, and to incorporate both individual and group-level influences.    Results  Higher levels of benzene emissions from petrochemical operations, both overall and in terms of specific pollution events, were associated with increased mortality rates for nearby residential populations, particularly in areas with socioeconomic deprivation. We identify uneven patterns of polluting practices within the industry, and locations that require epidemiological studies.    Conclusions  While petrochemical facilities in all European Union regions are regulated to be compliant with the annual average benzene limit of 5 μg/m 3 , uneven exposures still present regional health inequalities. We recommend extending benzene regulations to an hourly or daily limit, alongside the strengthening of regulation for other toxic petrochemical releases.

Regional inequalities in benzene exposures across the European petrochemical industry: A Bayesian multilevel modelling approach