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Review
. 2017 Feb;60(2):163-180.
doi: 10.1002/ajim.22655.

Non-malignant respiratory disease among workers in industries using styrene-A review of the evidence

Randall J Nett  1 , Jean M Cox-Ganser  1 , Ann F Hubbs  2 , Avima M Ruder  3 , Kristin J Cummings  1 , Yuh-Chin T Huang  4 , Kathleen Kreiss  1
Affiliations
Review

Non-malignant respiratory disease among workers in industries using styrene-A review of the evidence

Randall J Nett et al. Am J Ind Med. 2017 Feb.

Abstract

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Results: We analyzed 55 articles and two unpublished case reports.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.

Keywords: asthma; bronchiolitis obliterans; non-malignant respiratory disease; obliterative bronchiolitis; occupational asthma; occupational lung disease; styrene; styrol; vinylbenzene.

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Conflict of interest statement

Disclosure (Authors): The authors declare no conflicts of interest.

Disclosure by Ajim Editor of Record: Rodney Ehrlich declares that he has no competing or conflicts of interest in the review and publication decision regarding this article.

Figures

Figure 1
Figure 1
Flow diagram showing process for inclusion of studies exploring the association between occupational styrene exposure and non-malignant respiratory disease.
See this image and copyright information in PMC

References

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