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Non‐malignant respiratory disease among workers in industries using styrene—A review of the evidence
Author(s) -
Nett Randall J.,
CoxGanser Jean M.,
Hubbs Ann F.,
Ruder Avima M.,
Cummings Kristin J.,
Huang YuhChin T.,
Kreiss Kathleen
Publication year - 2017
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/ajim.22655
Subject(s) - medicine , styrene , asthma , bronchiolitis , risk factor , inhalation , disease , respiratory disease , respiratory system , lung , anesthesia , chemistry , organic chemistry , copolymer , polymer
Background Asthma and obliterative bronchiolitis (OB) cases have occurred among styrene‐exposed workers. We aimed to investigate styrene as a risk factor for non‐malignant respiratory disease (NMRD). Methods From a literature review, we identified case reports and assessed cross‐sectional and mortality studies for strength of evidence of positive association (i.e., strong, intermediate, suggestive, none) between styrene exposure and NMRD‐related morbidity and mortality. Results We analyzed 55 articles and two unpublished case reports. Ten OB cases and eight asthma cases were identified. Six (75%) asthma cases had abnormal styrene inhalation challenges. Thirteen (87%) of 15 cross‐sectional studies and 12 (50%) of 24 mortality studies provided at least suggestive evidence that styrene was associated with NMRD‐related morbidity or mortality. Six (66%) of nine mortality studies assessing chronic obstructive pulmonary disease‐related mortality indicated excess mortality. Conclusions Available evidence suggests styrene exposure is a potential risk factor for NMRD. Additional studies of styrene‐exposed workers are warranted. Am. J. Ind. Med. 60:163–180, 2017. © 2016 Wiley Periodicals, Inc.