Association Between Occupational Exposure to Gasoline and Anemia: a Retrospective Cohort Study in China

Overview

Journal BMC Public Health

Publisher Biomed Central

Date 2025 Jan 28

PMID 39871221

Authors

Lan Lin

Hongmei Cao

Beining Wu

Jin Wang

Lin Song

Weiling Chan

Geyang Li

Li Zhou

Jing Xiao

Lejia Zhu

Yulong Lian

Affiliations

Soon will be listed here.

Abstract

Background: Anemia is a major global burden, and occupational gasoline exposure is a common occupational hazard factor. Although previous studies have shown that there is a potential relationship between occupational gasoline exposure and the increase of anemia prevalence, this relationship has not been fully explored. The current cohort study aimed to investigate the association between occupational exposure to gasoline and anemia, and the effect of gasoline concentration on hemoglobin (Hb) levels.

Methods: This retrospective cohort study collected baseline data from 1451 workers, including 605 exposed to gasoline and 846 not exposed to gasoline. Participants were enrolled in 2013-2015, and follow-up in 2019. Anemia was diagnosed according to WHO guidelines on hemoglobin cutoffs to define anemia in individuals and populations. Occupational exposure concentration of gasoline was measured based on the Chinese national standard (GBZ-T300.62-2017). Logistic regression was conducted to analyze the associations of occupational exposure to gasoline and anemia.

Results: The incidence of anemia among workers exposed to gasoline was significantly higher than that among non-exposed workers (relative risk [RR] = 11.03, 95% confidence interval [CI]: 9.45-12.53). The risks of anemia were significantly higher among participants exposed to gasoline concentrations ≥ 43.20 mg/m³ (RR = 13.92, 95%CI: 12.25-15.28), 18.01-43.19 mg/m³ (RR = 12.93, 95%CI: 11.07-14.51), and 0.01-18.00 mg/m³ (RR = 5.49, 95%CI: 3.96-7.32) compared with the control non-exposed group. The risk of anemia was significantly higher among exposed workers, after adjusting for all confounding factors. There was also a significant negative correlation between gasoline exposure concentration and hemoglobin level.

Conclusions: Occupational exposure to gasoline is associated with an increased incidence of anemia, with a positive correlation between occupational gasoline exposure levels and the severity of anemia. The incidence and severity of anemia increase while hemoglobin levels decrease in line with increasing gasoline exposure concentrations. These findings emphasize the importance of assessing anemia in workers exposed to gasoline.

References

Cakmak S, Cole C, Hebbern C, Andrade J, Dales R . Associations between blood volatile organic compounds, and changes in hematologic and biochemical profiles, in a population-based study. Environ Int. 2020; 145:106121. DOI: 10.1016/j.envint.2020.106121. View

Wingate K, Pratt S, Ramirez-Cardenas A, Hagan-Haynes K . Risky driving behaviors and employer motor vehicle safety policies among U.S. oil and gas extraction workers. J Safety Res. 2023; 86:12-20. PMC: 10505701. DOI: 10.1016/j.jsr.2023.05.015. View

. Global, regional, and national prevalence and mortality burden of sickle cell disease, 2000-2021: a systematic analysis from the Global Burden of Disease Study 2021. Lancet Haematol. 2023; 10(8):e585-e599. PMC: 10390339. DOI: 10.1016/S2352-3026(23)00118-7. View

Kponee K, Chiger A, Kakulu I, Vorhees D, Heiger-Bernays W . Petroleum contaminated water and health symptoms: a cross-sectional pilot study in a rural Nigerian community. Environ Health. 2015; 14:86. PMC: 4636824. DOI: 10.1186/s12940-015-0073-0. View

Moro A, Brucker N, Charao M, Sauer E, Freitas F, Durgante J . Early hematological and immunological alterations in gasoline station attendants exposed to benzene. Environ Res. 2015; 137:349-56. DOI: 10.1016/j.envres.2014.11.003. View

Marcus H, Schauer C, Zlotkin S . Effect of Anemia on Work Productivity in Both Labor- and Nonlabor-Intensive Occupations: A Systematic Narrative Synthesis. Food Nutr Bull. 2021; 42(2):289-308. DOI: 10.1177/03795721211006658. View

Chaparro C, Suchdev P . Anemia epidemiology, pathophysiology, and etiology in low- and middle-income countries. Ann N Y Acad Sci. 2019; 1450(1):15-31. PMC: 6697587. DOI: 10.1111/nyas.14092. View

Kachuri L, Villeneuve P, Parent M, Johnson K, Harris S . Workplace exposure to diesel and gasoline engine exhausts and the risk of colorectal cancer in Canadian men. Environ Health. 2016; 15:4. PMC: 4712563. DOI: 10.1186/s12940-016-0088-1. View

Jabbar A, Ali E . Impact of Petroleum Exposure on Some Hematological Indices, Interleukin-6, and Inflammatory Markers of Workers at Petroleum Stations in Basra City. J Environ Public Health. 2020; 2020:7693891. PMC: 7424534. DOI: 10.1155/2020/7693891. View

10.

Figueiredo A, Gomes-Filho I, Silva R, Pereira P, da Mata F, Lyrio A . Maternal Anemia and Low Birth Weight: A Systematic Review and Meta-Analysis. Nutrients. 2018; 10(5). PMC: 5986481. DOI: 10.3390/nu10050601. View

11.

Monyarch G, de Castro Reis F, Zock J, Giraldo J, Pozo-Rodriguez F, Espinosa A . Chromosomal bands affected by acute oil exposure and DNA repair errors. PLoS One. 2013; 8(11):e81276. PMC: 3841120. DOI: 10.1371/journal.pone.0081276. View

12.

Ebea-Ugwuanyi P, Vidyasagar S, Connor J, Frazer D, Knutson M, Collins J . Oral iron therapy: Current concepts and future prospects for improving efficacy and outcomes. Br J Haematol. 2024; 204(3):759-773. PMC: 10939879. DOI: 10.1111/bjh.19268. View

13.

Pasricha S, Rogers L, Branca F, Garcia-Casal M . Measuring haemoglobin concentration to define anaemia: WHO guidelines. Lancet. 2024; 403(10440):1963-1966. DOI: 10.1016/S0140-6736(24)00502-6. View

14.

Gelaw Y, Getaneh Z, Melku M . Anemia as a risk factor for tuberculosis: a systematic review and meta-analysis. Environ Health Prev Med. 2021; 26(1):13. PMC: 7824931. DOI: 10.1186/s12199-020-00931-z. View

15.

Owumi S, Oladimeji B, Elebiyo T, Arunsi U . Combine effect of exposure to petrol, kerosene and diesel fumes: On hepatic oxidative stress and haematological function in rats. Toxicol Ind Health. 2021; 37(6):336-352. DOI: 10.1177/07482337211012498. View

16.

Swann J, Koneva L, Regan-Komito D, Sansom S, Powrie F, Griseri T . IL-33 promotes anemia during chronic inflammation by inhibiting differentiation of erythroid progenitors. J Exp Med. 2020; 217(9). PMC: 7478740. DOI: 10.1084/jem.20200164. View

17.

Akbarpour E, Paridar Y, Mohammadi Z, Mard A, Danehchin L, Abolnezhadian F . Anemia prevalence, severity, types, and correlates among adult women and men in a multiethnic Iranian population: the Khuzestan Comprehensive Health Study (KCHS). BMC Public Health. 2022; 22(1):168. PMC: 8787906. DOI: 10.1186/s12889-022-12512-6. View

18.

Garcia-Casal M, Dary O, Jefferds M, Pasricha S . Diagnosing anemia: Challenges selecting methods, addressing underlying causes, and implementing actions at the public health level. Ann N Y Acad Sci. 2023; 1524(1):37-50. PMC: 10880862. DOI: 10.1111/nyas.14996. View

19.

Alses M, Alzeer S . Evaluation of some biological parameters of gasoline station attendants in Damascus, Syria. Heliyon. 2021; 7(5):e07056. PMC: 8144008. DOI: 10.1016/j.heliyon.2021.e07056. View

20.

Caiado F, Pietras E, Manz M . Inflammation as a regulator of hematopoietic stem cell function in disease, aging, and clonal selection. J Exp Med. 2021; 218(7). PMC: 8210622. DOI: 10.1084/jem.20201541. View