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Epidemiologic Studies of Styrene and Cancer: A Review of the Literature

Boffetta, Paolo MD, MPH; Adami, Hans Olov MD, PhD; Cole, Philip MD, DrPH; Trichopoulos, Dimitrios MD, PhD; Mandel, Jack S. PhD, MPH

Journal of Occupational & Environmental Medicine: November 2009 - Volume 51 - Issue 11 - pp 1275-1287
doi: 10.1097/JOM.0b013e3181ad49b2
Original Articles

Objective: To review the epidemiologic literature on styrene and cancer.

Methods: We reviewed studies of workers exposed to styrene in manufacturing and polymerization, in the reinforced plastics industry, and in styrene-butadiene rubber production. We also reviewed studies of workers monitored for styrene exposure, studies of environmental exposure, community-based case-control studies of lymphoma and leukemia, and studies of DNA adducts. Studies of workers in the reinforced plastics industry were considered more informative because of higher worker exposure and less confounding by other carcinogens.

Results: We found no consistent increased risk of any cancer among workers exposed to styrene. A study of reinforced plastic workers reported an association between average estimated styrene exposure and non-Hodgkin lymphoma (NHL, P = 0.05) but no trend with increasing duration of exposure. Other studies of styrene exposure and NHL found no increased risk. In two US studies of reinforced plastic workers, esophageal cancer mortality was increased, but these findings were generated in a background of multiple comparisons. Results for other cancers were unremarkable.

Conclusions: The available epidemiologic evidence does not support a causal relationship between styrene exposure and any type of human cancer.

From International Prevention Research Institute (Dr Boffetta), Lyon, France; Department of Epidemiology (Dr Adami, Dr Trichopoulos), Harvard School of Public Health, Boston, Mass; School of Public Health (Dr Cole), University of Alabama, Birmingham, Ala; Dalla Lana School of Public Health (Dr Mandel), University of Toronto, Toronto, Ontario, Canada.

Address correspondence to: Jack Mandel, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Room 638, Toronto, ON M5T 3M7, Canada; E-mail: jack.mandel@utoronto.ca.

©2009The American College of Occupational and Environmental Medicine