How benzene exposure leads to leukemia
Railroad workers are exposed to benzene from diesel exhaust, fuel handling, engine maintenance and solvents used for repair work, often inside enclosed locomotive cabs and rail yards where poor ventilation leads to higher vapor concentrations. Once absorbed, benzene travels to the bone marrow, where blood cells are produced, and initiates a progressive pattern of destruction:
- Hematopoietic stem cells develop chromosomal abnormalities that interfere with normal blood cell development
- Damaged stem cells begin to multiply abnormally, inhibiting the formation of healthy blood
- Over time, this cellular disruption progresses to AML
A large meta-analysis found a dose-response relationship between cumulative benzene exposure and leukemia risk, with AML being the most strongly and consistently associated. A cohort study of over 73,000 benzene-exposed workers found significantly increased incidence of AML and myelodysplastic syndrome in heavily exposed groups.
The landmark Pliofilm cohort, used as a basis for EPA regulatory risk assessments, found workers in high benzene exposure categories carried significantly elevated AML mortality with a clear exposure-response pattern.